Surgical apparatus

ABSTRACT

The disclosure provides a surgical apparatus comprising: a steerable member that is bendable and comprises a plurality of bending segments with channels therein; and a plurality of bending actuation wires that are arranged to pass through the steerable member and cause the steerable member to bend, the steerable member comprising at least one outwardly opening lumen through which the bending actuation wires pass.

CROSS-REFERENCE TO RELATED APPLICATIONS

This Application is a divisional of application Ser. No. 15/562,594,filed Feb. 3, 2017, which claims priority to 371 U.S. National Stage ofInternational Application No. PCT/US2017/016485, filed Feb. 3, 2017, andclaims the benefit of priority from U.S. Provisional Application No.62/292,057, filed Feb. 7, 2016, entitled “SURGICAL APPARATUS,” and U.S.Provisional Application No. 62/424,273, filed Nov. 18, 2016, entitled“SURGICAL APPARATUS,” which are fully incorporated by reference hereinin their entirety.

BACKGROUND Field

The present invention relates to a surgical apparatus, and moreparticularly, to a surgical apparatus which is capable of performing abending mechanism by including a bendable element at the distal end.

Description of the Related Art

Surgical apparatuses used in surgery have different structures dependingon the location of a surgical site and how the surgical site will betreated. In recent years, various types of surgical equipment using arobot are being developed to perform surgery on areas where surgicalsites are difficult to access by existing surgical apparatuses or toperform a minimal invasive surgery. These surgical apparatuses areconfigured to move in various directions in the human body by includinga bendable element, which are disclosed in many documents including U.S.Pat. No. 6,858,005.

Surgical apparatuses bendable at the distal end bend by the movement ofwires inside them. However, these surgical apparatuses are hard tofinely manipulate, revealing some problems like creating backlash whenthey are bent with the wires or restricting the movement of other wires.Also, these surgical apparatuses have many components embedded in themwhich are connected to one another in a complicated way, so it isdifficult to miniaturize them.

SUMMARY

Embodiments of the present invention may provide a surgical apparatuscomprising: a steerable member that is bendable and comprises aplurality of bending segments with channels therein; and a plurality ofbending actuation wires that are arranged to pass through the steerablemember and cause the steerable member to bend, the steerable membercomprising at least one lumen through which the bending actuation wirespass, and the lumen being partially open outward.

Other embodiments of the surgical apparatus may further comprise an endeffector provided at the distal end of the steerable member; and aneffector actuation wire connected to the end effector to actuate the endeffector, at least part of the end effector being detachably provided atthe distal end of the effector actuation wire.

A wire termination member for fixing the distal ends of the bendingactuation wires may be provided at the distal end of the steerablemember, and the bending actuation wires may be fixed by screwing thewire termination member.

The surgical apparatus may further comprise: a flexible membercomprising a flexible material that is provided at the proximal end ofthe steerable member and; and at least one sleeve forming a path oftravel of a wire passing through the steerable member or the flexiblemember, both ends of which are fixed to the inside of the steerablemember of flexible member.

Screw members may be provided on the bending actuation wires,respectively, and the steerable member bends as the screw members movemechanically in sync with each other.

BRIEF DESCRIPTION OF THE DRAWINGS

Hereinafter, a surgical apparatus according to exemplary embodiments ofthe present invention will be described concretely with reference to thedrawings. A description of the positional relationship between thecomponents will now be made basically with reference to the drawings. Inthe drawings, structures of the embodiments may be simplified orexaggerated for clarity. Accordingly, the present invention is notlimited to these exemplary embodiments, but instead various kinds ofdevices may be added, changed, or omitted.

The exemplary embodiments will be described with respect to a surgicalapparatus that has a plurality of passages inside an insertion part,with various kinds of surgical instruments located in each passage.However, it is to be noted that the present invention is not limited tothis exemplary embodiment and is applicable to a variety of surgicalapparatuses, including catheters, endoscopes, and surgical robots, thatare bendable at the distal end.

FIG. 1A is an isometric view of a distal end of the surgical apparatusincluding a manipulating part and an insertion part. FIG. 1B is anenlarged isometric view of the insertion part in FIG. 1A.

FIG. 2 is a cross-sectional view of one of the surgical instruments ofFIG. 1A.

FIG. 3A is a schematic plan view of two adjacent bending segments of thesteerable member in a neutral state. FIG. 3B is a schematic plan view ofthe adjacent bending segments in a bent state.

FIG. 4 is a schematic plan view illustrating a slack in a wire accordingto an improved bending segment structure.

FIG. 5A is a partial isometric view of the bending segments. FIG. 5B isa longitudinal section view of the bending segments of FIG. 5A.

FIG. 6A is a partial isometric view of the bending segments having aprotrusion with a round surface according to an embodiment of thepresent invention.

FIG. 6B is a partial isometric view of the bending segments having aprotrusion with a linear edge at the end according to another embodimentof the present invention.

FIG. 7A is an isometric view of a bending segment of a plurality ofbending segments according to one embodiment of the present invention.FIG. 7B is an isometric view of a plurality of bending segments of FIG.7A.

FIG. 8A is an isometric view of a bending segment according to anotherembodiment of the present invention. FIG. 8B is an isometric view of aplurality of the bending segments of FIG. 8A.

FIG. 9A is an isometric view of a bending segment having a recess partaccommodating the connecting part according to an embodiment of thepresent invention. FIG. 9B is an isometric view of a bending segmenthaving a recess part with a v-shaped notch-like groove according toanother embodiment of the present invention.

FIG. 10 is an isometric view of a steerable member using a flexiblehinge structure.

FIG. 11 is an isometric view of a steerable member using a flexiblebackbone structure.

FIG. 12A is a schematic sectional view of a bending segment in a neutralstate. FIG. 12B is a schematic sectional view of the bending segment ofFIG. 12A in a bent state. FIG. 12C is a schematic sectional view of thebending segment of FIG. 12B returning to a neutral state.

FIGS. 13A to 13F are views illustrating various exemplary embodiments ofa steerable member having different arrangements of the bendingactuation wires and lateral supporting members, wherein FIG. 13A is anisometric view of a steerable member according to a first exemplaryembodiment; FIG. 13B is an isometric view of a steerable memberaccording to a second exemplary embodiment; FIG. 13C is an isometricview of a steerable member according to a third exemplary embodiment;

FIG. 13D is an isometric view of a steerable member according to afourth exemplary embodiment; FIG. 13E is an isometric view of asteerable member according to a fifth exemplary embodiment; and FIG. 13Fis an enlarged view of the lateral supporting members and the bendingactuation wires of the third exemplary embodiment of FIG. 13D.

FIG. 14A is a schematic sectional view of a steerable member with alateral supporting member in a neutral state without any manipulation.FIG. 14B is a schematic sectional view of a steerable member with apre-shaped lateral supporting member in a state that a first tensileforce F is applied to. FIG. 14C is a schematic sectional view of asteerable member with a pre-shaped lateral supporting member in a statethat a second tensile force F′ is applied thereto.

FIG. 15A is a schematic view of the adjacent bending segment beforebending. FIG. 15B is a schematic view of the adjacent bending segmentwhen being bent to a radius of curvature R.

FIG. 16A is an isometric view illustrating a connecting segment andbending segments connected by the connecting segment. FIG. 16B is anisometric view of the connecting segment of FIG. 16A.

FIG. 17A is an isometric view of the steerable member comprising aplurality of connecting segments in a neutral state. FIG. 17 B is anisometric view of the steerable member comprising a plurality ofconnecting segments in a bent state.

FIG. 18A is a schematic plan view of two adjacent bending segments of asteerable member having a path adjusting member in a neutral state. FIG.18B is a schematic plan view of the adjacent bending segments of FIG.18A in a bent state;

FIG. 19A is an isometric view of the steerable member comprisingplate-like bending segments and wall-like connecting parts. FIG. 19B isan isometric view of the steerable member of FIG. 19A with the bendingactuation wires located inside the path adjusting member in each lumen.

FIG. 20A is a cross-sectional view of the steerable member in a neutralstate. FIG. 20B is a cross-sectional view of the steerable member ofFIG. 20A where the bending is concentrated at the distal end of thesteerable member.

FIG. 21A is a cross-sectional view of the steerable member comprising ageometrically enhanced structure according to one exemplary embodimentof the present invention. FIG. 21B is a cross-sectional view of thesteerable member comprising a geometrically enhanced structure accordingto another exemplary embodiment of the present invention. FIG. 21C is across-sectional view of the steerable member comprising a geometricallyenhanced structure according to yet another exemplary embodiment of thepresent invention.

FIGS. 22A to C are isometric views illustrating a method of fixingbending actuation wires by a wire termination member, wherein FIG. 22Aillustrates the wire termination member being threaded to the distal endof the steerable member; FIG. 22B illustrates bending actuation wiresbeing fixed when the wire termination member is threaded; and FIG. 22Cillustrates the steerable member after the bending actuation wires isfixed.

FIG. 23 is an isometric view of an end effector being used as a wiretermination member according to another exemplary embodiment of thepresent invention.

FIG. 24A is a cross-sectional view of the end effector of FIG. 23 in afirst mode. FIG. 24B is a cross-sectional view of the end effector ofFIG. 23 in a second mode.

FIG. 25 is an exploded view of an end effector using an elastic bodyaccording to one embodiment of the present invention.

FIG. 26A is a cross-sectional view of an end effector having an effectoractuation wire according to one embodiment of the present invention.FIG. 26B is an enlarged sectional view of the distal end of thesteerable member of the end effector of FIG. 26A. FIG. 26C is anenlarged sectional view of the proximal end of the end effector of FIG.26A.

FIG. 27A is a cross-sectional view of an end effector having a bendingactuation wire according to one embodiment of the present invention.FIG. 27B is an enlarged cross sectional view of the distal end of thesteerable member of the end effector of FIG. 27A. FIG. 27C is anenlarged cross sectional view of the proximal end of the end effector ofFIG. 27A.s

FIG. 28A is a cross-sectional view of an end effector having a bendingactuation wire with two bendable portions according to one embodiment ofthe present invention. FIG. 28B is an enlarged cross sectional view ofthe distal end of the steerable portion of FIG. 28A. FIG. 28C is anenlarged sectional view of the proximal end of the flexible member ofFIG. 28A.

FIG. 29A is a cross-sectional view of an end effector having a bendingactuation wire with two bendable portions according to anotherembodiment of the present invention. FIG. 29B is an enlarged sectionalview of the proximal end steerable portion of FIG. 29A. FIG. 29C is anenlarged sectional view of the proximal end of the end effector of FIG.29A.

FIG. 30 is a schematic isometric view illustrating a connectingstructure of the end of a surgical instrument and a manipulating part.

FIG. 31A is a schematic plan view of a manipulating part comprising asingle screw member according to one embodiment of the presentinvention, wherein a first bending actuation wire and a second bendingactuation wire move respectively in opposite directions on a straightline. FIG. 31B is a schematic plan view of the manipulating part of FIG.31A, wherein a first bending actuation wire and a second bendingactuation wire move respectively in reverse directions of FIG. 31A.

FIG. 32 is a schematic plan view of a manipulating part comprising apair of screw members and a driving part according to one embodiment ofthe present invention.

FIG. 33A is a schematic view showing the length of the bending actuationwire before bending in an ideal continuous flexible arm. FIG. 33B is aschematic view showing the length of the bending actuation wire afterbending in an ideal continuous flexible arm.

FIG. 34A is a schematic view showing the length of the bending actuationwire before bending in the actual condition. FIG. 34B is a schematicview showing the length of the bending actuation wire after bending inthe actual condition.

FIG. 35 is an isometric view illustrating an exemplary bending segmentaccording to an exemplary embodiment of the present invention.

FIG. 36 is an isometric view illustrating an exemplarytension-regulating member in FIG. 35 according to an exemplaryembodiment of the present invention.

FIGS. 37A and B illustrate pivotal motion of one of the exemplarytension-regulating member of FIG. 36, wherein FIG. 37A is a front viewof the tension-regulating member bending to the left side, and FIG. 37Bis a front view of the tension-regulating member bending to the rightside.

FIGS. 38A and B are schematic views illustrating a slack in a wire beingimproved according to the exemplary tension-regulating member structurein FIG. 36, wherein FIG. 38 A shows the length of the bending actuationwire before bending, and FIG. 38 B shows the length of the bendingactuation wire after bending.

FIG. 39 is a diagram of the simulation result illustrating that thetotal length change (ΔL) of the bending actuation wire change as afunction of the bending angle θ.

FIG. 40 is a block diagram illustrating a surgical instrument accordingto an exemplary embodiment of the present invention.

FIG. 41 is a schematic view illustrating a surgical instrument accordingto an exemplary embodiment of the present invention.

FIG. 42 is a schematic view illustrating a surgical instrument in abending motion according to an exemplary embodiment of the presentinvention.

FIG. 43 is a block diagram illustrating a surgical instrument accordingto another exemplary embodiment of the present invention.

FIG. 44 is a schematic view illustrating a surgical instrument accordingto another exemplary embodiment of the present invention.

FIG. 45 is a block diagram illustrating a personalized master controlleraccording to an exemplary embodiment of the present invention.

FIG. 46 is a schematic isometric view illustrating a personalized mastercontroller according to an exemplary embodiment of the presentinvention.

FIG. 47 is a schematic isometric view illustrating a control platformand a connecting part according to an exemplary embodiment of thepresent invention.

FIGS. 48A-E are views illustrating three types of the interchangeablegrips according to an exemplary embodiment of the present inventionwherein FIG. 48A is an isometric view of a grip-type interchangeablegrip connected to an inner gimbal structure, FIG. 48B is an isometricview of the interchangeable grip of FIG. 48A detached from the innergimbal structure, FIG. 48C is an isometric view of a tweezers-typeinterchangeable grip connected to an inner gimbal structure, FIG. 48D isan isometric view of the interchangeable grip of FIG. 48C detached fromthe inner gimbal structure, FIG. 48E is an isometric view of alaparoscopic-hand-instrument type interchangeable grip connected to aninner gimbal structure, and FIG. 48F is an isometric view of theinterchangeable grip of FIG. 48E detached from the inner gimbalstructure.

FIG. 49 is an isometric view schematically illustrating a personalizedmaster controller according to another embodiment of the presentinvention.

FIG. 50 is an isometric view schematically illustrating parts (i.e. thebase member, the moveable member, and three parallel kinematics chain)of the control platform of the personalized master controller in FIG.49.

FIG. 51 is an enlarged view of a portion of FIG. 49 showing theinterchangeable grip being attached to the moveable member of thecontrol platform according to an exemplary embodiment of the presentinvention.

FIG. 52 is an enlarged view of a portion of FIG. 49 showing theinterchangeable grip being detached from the moveable member of thecontrol platform according to an exemplary embodiment of the presentinvention.

DETAILED DESCRIPTION

The invention and the various features and advantageous details thereofare explained more fully with reference to the non-limiting embodimentsthat are illustrated in the accompanying drawings and detailed in thefollowing description. Descriptions of well-known materials,manufacturing techniques, parts, and equipment are omitted so as not tounnecessarily obscure the invention in detail. It should be understood,however, that the detailed description and the specific examples, whileindicating preferred embodiments of the invention, are given by way ofillustration only and not by way of limitation. Various substitutions,modifications, additions and/or rearrangements within the spirit and/orscope of the underlying inventive concept will become apparent to thoseskilled in the art from this disclosure.

Hereinafter, a surgical apparatus according to an exemplary embodimentof the present invention will be described concretely with reference tothe drawings. A description of the positional relationship between thecomponents will now be made basically with reference to the drawings. Inthe drawings, structures in the embodiment may be simplified orexaggerated for clarity. Accordingly, the present invention is notlimited to this exemplary embodiment, but instead various kinds ofdevices may be added, changed, or omitted.

This exemplary embodiment will be described with respect to a surgicalapparatus that has a plurality of passages inside an insertion part,with various kinds of surgical instruments located in each passage.However, it is to be noted that the present invention is not limited tothis exemplary embodiment and is applicable to a variety of surgicalapparatuses, including catheters, endoscopes, and surgical robots, thatare bendable at the distal end.

FIG. 1 is a view illustrating a surgical apparatus according to anexemplary embodiment of the present invention. As illustrated in FIG. 1,a surgical apparatus 1 comprises an insertion part 20 provided at thedistal end of the surgical apparatus and a manipulating part 10 locatedat the proximal end of the insertion part 20.

The insertion part 20 forms a part that is inserted into a surgical siteduring surgery. The insertion part 20 consists of a flexible tube, inwhich at least one surgical instrument 30 for use in a surgicaloperation is located. The surgical instrument 30 may be selectivelylocated in at least one hollow passage that is formed inside theinsertion part 20. Alternatively, the surgical instrument 30 may beembedded in the insertion part 20. The surgical instrument 30, stickingout of the distal end of the insertion part 20, may be used in surgeryor capture images of the surgical site.

The surgical apparatus of FIG. 1 comprises an insertion part 20 withfour passages, each passage including four surgical instruments 30. InFIG. 1, two out of the four surgical instruments include forceps 31 asend effectors 300 at the distal end. Such surgical instruments mayperform various surgical operations by manipulating the forceps.Besides, other various types of surgical elements including blades,suturing units, needles, etc. can be used. One of the remaining twosurgical instruments is an imaging unit 32. The imaging unit 32 maycapture images of the distal end by including an optical device such asan optical fiber. The other surgical instrument may be a lumen unit 33with a working channel in it through which various instruments can beinserted.

These surgical instruments 30, sticking out of the distal end of theinsertion part 20, are configured such that their protruding end canbend. Accordingly, the bending of the surgical instruments 30 allows forperforming a surgical operation in different directions or taking imagesfrom different directions. The surgical instruments 30 may bend by themovement of a plurality of wires inside them, which will be described indetail below.

The manipulating part 10 is provided at the proximal end of theinsertion part 20, and configured to manipulate the insertion part 20and/or the surgical instruments 30. The distal end of the manipulatingpart 10 is connected to the proximal end of the insertion part 20, andmay be detachably connected thereto in this exemplary embodiment. Atleast one driving part is provided in the manipulating part 10. Thedriving part 40 is mechanically connected to the insertion part 20and/or various types of wire members of the surgical instruments 30, andthe driving part 40 enables various motions of the insertion part 20and/or surgical instruments 30, including bending movement of thesurgical instruments 30.

Hereinafter, a detailed configuration of the above-described surgicalapparatus will be explained in more detail with reference to thedrawings.

FIG. 2 is a cross-sectional view of one of the surgical instruments ofFIG. 1. As illustrated in FIG. 2, the surgical instrument 30 comprises asteerable member 100 at the distal end that is bendable. The steerablemember 100 has a plurality of bending segments 110 with hollow channels(not shown) that are connected together. A flexible member 200comprising a flexible material is provided at the proximal end of thesteerable member 100. The flexible member 200 may consist of a hollowtube where various types of wire members connected from the distal endof the surgical instrument 30 are located. Optionally, an end effector300 is provided at the distal end of the steerable member 100, and theend effector 300 may be selectively actuated by an effector actuationwire 500.

Each bending segment 110 of the steerable member 100 is connected toadjacent bending segments in a way that allows hinge movement, and bentby means of bending actuation wires 400. The bending actuation wires 400are located in such a way as to pass through the steerable member 100and the flexible member 200, and the distal ends of the bendingactuation wires 400 are connected to the steerable member 100 and theirproximal ends are mechanically connected to the manipulating part 10.Each bending segment 110 comprises a plurality of lumens 112 that areformed lengthwise, and the bending actuation wires 400 are locatedwithin the lumens 112 (FIG. 5A). Accordingly, when the bending actuationwires 400 are moved by the manipulating part 10, the plurality ofbending segments 110 move hingedly, thus causing the steerable member100 to bend.

FIGS. 3A and 3B are views schematically illustrating a slack in a wiredue to bending of the steerable member. Let the bending segments 110have a length of L and a width of 2r. Adjacent bending segments 110 arehinged at the middle on their facing sides (which is at a distance of rfrom the outer perimeter). Let the bending actuation wires 400 belocated on two opposite sides of the width of each bending segment andpass through the middle of the length of each bending segment (which isat a distance of L from each hinged portion).

FIG. 3A illustrates the steerable member in a neutral state beforebending, and FIG. 3B illustrates the steerable member when being bent toa radius of curvature R. In FIG. 3B, the angle of bend between twobending segments 110 is denoted by θ. The following equation is tocompare the sum of the lengths of two wire portions between the twobending segments before bending and the sum of the lengths of the twowire portions after bending. If the lengths of the two wire portionsbefore bending are denoted by L₁ and L₂, respectively, and the lengthsof the two wire portions after bending are denoted by L₁′ and L₂′,respectively, the difference ΔL between the two lengths is as follows:

$L_{1} = {L_{2} = {L = {2R\;{\tan\left( \frac{\theta}{2} \right)}}}}$${{L_{1}}^{\prime} + {L_{2}}^{\prime}} = {{{2\left( {R + r} \right){\sin\left( \frac{\theta}{2} \right)}} + {2\left( {R - r} \right){\sin\left( \frac{\theta}{2} \right)}}} = {4R\mspace{14mu}{\sin\left( \frac{\theta}{2} \right)}}}$${\Delta\; L} = {{L_{1} + L_{2} - L_{1}^{\prime} - L_{2}^{\prime}} = {4{R\left( {{\tan\left( \frac{\theta}{2} \right)} - {\sin\left( \frac{\theta}{2} \right)}} \right)}}}$

As seen from above, the sum of the lengths of the two wire portionsbetween the two bending segments after bending is smaller than thatbefore bending. Accordingly, when the wires on both sides aremanipulated in conjunction with each other, a slack of ΔL is producedbetween each bending segment. This is because, when bending occurs, theamount of change (L₁′−L₁) in the length of the wire on the other side ofthe center of curvature is smaller than the amount of change (L₂−L₂′) inthe length of the wire near the center of curvature. Accordingly,backlash is created due to bending, thus making fine adjustmentdifficult.

In contrast, in this exemplary embodiment, the bending segments may beconfigured in various shapes to minimize the slack caused by bending.FIG. 4 is a view schematically illustrating a slack in a wire accordingto an improved bending segment structure. As illustrated in FIG. 4, theimproved bending segments 110 are configured in such a way that part ofthe lumens 112 where the bending actuation wires are located is open(see FIG. 5). Herein, t denotes the length of an open lumen portion.While the wire near the center of curvature has the shorter path due tothe open lumen portion, the wire on the other side of the center ofcurvature has the path to which an extra length is added at thecorresponding open lumen portion. In this case, the path L₂* of the wirenear the center of curvature is equal in length to the previous path(L₂′ of FIG. 3), and the path L₁* of the wire on the other side of thecenter of curvature is longer than the previous path (L₁′ of FIG. 3).This increase in path length is because a sidewall of the open lumenportion (near the center of the bending segments) on the other side ofthe center of curvature forms a stumbling portion 114 and the bendingactuation wire 400 passing through the path stumbles against thestumbling portion 114 (see FIG. 5). Accordingly, when bending occursusing the improved bending segments, ΔL is as follows:

$\mspace{79mu}{L_{1} = {L_{2} = {L = {2R\;{\tan\left( \frac{\theta}{2} \right)}}}}}$$\mspace{79mu}{L_{1}^{*} = {{L_{1}^{\prime} - {2t\;{\cos\left( \frac{\theta}{2} \right)}} + {2t}} = {L_{1}^{\prime} + {2{t\left( {1 - {\cos\left( \frac{\theta}{2} \right)}} \right)}}}}}$${L_{1}^{*} + {L_{2}}^{\prime}} = {{{2\left( {R + r} \right){\sin\left( \frac{\theta}{2} \right)}} + {2\left( {R - r} \right){\sin\left( \frac{\theta}{2} \right)}} + {2{t\left( {1 - {\cos\left( \frac{\theta}{2} \right)}} \right)}}} = {{4R\;{\sin\left( \frac{\theta}{2} \right)}} + {2{t\left( {1 - {\cos\left( \frac{\theta}{2} \right)}} \right)}}}}$$\mspace{79mu}{{\Delta\; L} = {{L_{1} + L_{2} - L_{1}^{*} - L_{2}^{\prime}} = {{4{R\left( {{\tan\left( \frac{\theta}{2} \right)} - {\sin\left( \frac{\theta}{2} \right)}} \right)}} - {2{t\left( {1 - {\cos\left( \frac{\theta}{2} \right)}} \right)}}}}}$

As stated above, with the improved bending segments 110 configured toreduce the length ΔL of the slack, the movement of the surgicalapparatus 1 can be finely controlled. Generally, the length t of theopen lumen portions may be 10% or more of the length L of the bendingsegments. Although the amount of reduction in the length ΔL of the slackdiffers depending on the dimension, angle of bend, etc. of the bendingsegments, the length ΔL of the slack may be reduced by approximately 30%or more.

The improved bending segments may be designed in various ways.Hereinafter, various exemplary embodiments of the bending segments willbe described in detail with reference to FIGS. 5 to 11.

FIGS. 5A and 5B are views illustrating a structure of bending segmentswith 1 degree of freedom. The bending segments 110 shown in FIGS. 5A and5B have a body with hollow channels 111 formed within them. One pair ofconnecting parts 120 is provided on one end of the length of the bodyand other one pair of connecting parts 120 is provided on the oppositeend. Each pair of connecting parts 120 is located facing each other ontwo opposite sides of the width of the body, with a hollow channel 111midway between them.

Each bending segment 110 is hinged to adjacent bending segments, andconnected to them by the connecting parts coupled to those of theadjacent ones. In FIG. 5A, the connecting parts 120 are connected bypinning them together. As hinge shafts of the connecting parts 120 allhave the same orientation, the steerable member of FIG. 5B has 1 degreeof freedom at which it bends to the left or right (as shown in thedrawing).

Each bending segment 110 includes a pair of lumens 112 in which thebending actuation wires are located. The pair of lumens 112 may beformed by penetrating through the wall surface of a hollow body, andthey are arranged symmetrically about the center of a cross-section ofthe bending segment 110, spaced a predetermined distance from eachother.

As shown in FIGS. 5A and 5B, the lumens of the bending segments 110 arepartially open. Specifically, each lumen comprises a closed lumenportion 112 b and an open lumen portion 112 a. In the closed lumenportion 112 b, the inner and outer sides are enclosed by wall surfacesas shown in FIG. 5, so that the bending actuation wire moves only withinthe lumen due to the sidewall structure. In contrast, in the open lumenportion 112 a, at least part of its sidewalls has an open structure.Accordingly, the bending actuation wire located in the open lumenportion 112 a is movable outside the lumen through the open portion.

In this exemplary embodiment, the open lumen portion 112 a has astructure in which a sidewall 113 a on the outer side of the bendingsegment (which is on the opposite side of the center of a cross-sectionof the bending segment) is open. Accordingly, when bending occurs, thewire 400 a near the center of curvature moves to an open portion(outward direction) of the open lumen portion, which enables the bendingsegments to be connected on a shorter length, as compared with theclosed lumen portion. On the contrary, a sidewall 113 b of the openlumen portion (near the center of the cross-section of the bendingsegment), if located on the other side of the center of curvature, formsa stumbling portion 114 against which a wire stumbles. Accordingly, whenbending occurs, the wire 400 b on the other side of the center ofcurvature is brought into more contact with the bending segment as itstumbles against the stumbling portion 114, thereby reducing the lengthof the slack.

In FIG. 5B, each lumen 112 of the bending segments 110 is configured insuch a way that a closed lumen portion 112 b is formed at the middle ofthe lumen length and an open lumen portion 112 a is located on eitherside of the closed lumen portion 112 b. This is merely an example, andone side of the lumen 112 along the length may form an open lumenportion and the other side may form a closed lumen portion.Alternatively, the open lumen portions of a pair of adjacent bendingsegments may be arranged symmetrically with respect to the hinge shafts.In this way, the lumens where the bending actuation wires are locatedmay be variously altered in such a way that a wall surface (inner wallsurface) 113 b near the center of a cross-section of the bendingsegments is longer than a wall surface (outer wall surface) 113 a on theother side of the center of the cross-section thereof.

Although FIG. 5B illustrates that the open lumen portion 112 a is longerthan the closed lumen portion 112 b, the present invention is notlimited thereto and may have various configurations depending on thestructure of the bending segments and the angle of bend. It should benoted that the length of the open lumen portion occupying 20% or more ofthe entire lumen length may be advantageous to reducing the length ofthe slack.

The connecting parts of the bending segments can be formed in variousways, other than pinning the connecting parts together as shown in FIGS.5A and 5B. FIGS. 6A and 6B illustrate an example of a different type ofconnecting parts.

The bending segments of FIGS. 6A and 6B each include a pair ofconnecting part 120 on one side and a pair of recess parts 121 on theother side. The connecting parts 110 of a bending segment 110 areaccommodated in the recess parts 121 of an adjacent bending segment andhinged to them. The connecting parts 120 of FIG. 6A each consist of aprotrusion with a round surface, and the recess parts 121 each areconfigured to accommodate the protrusion. Accordingly, each connectingpart 120 moves hingedly as it rotates within the corresponding recesspart 121. The connecting parts 120 of FIG. 6B each consist of aprotrusion with a linear edge at the end, and the recess parts 121 eachhave a v-shaped notch-like groove. Accordingly, the connecting parts 120can move hingedly as the area of contact with the recess parts 121rotates about the axis of rotation, while they are in linear contactwith the recess parts 121.

FIGS. 7A and 7 b are views illustrating a structure of bending segmentswith 2 degrees of freedom. The bending segments of FIG. 7B each areconnected to adjacent bending segments in a way that allows hingemovement, and configured in such a way that a hinge shaft h1 connectedto a bending segment on one side and a hinge shaft h2 connected to abending segment on the other side have different orientations.Accordingly, the bending segments 100 of FIGS. 7A and 7B constitute asteerable member that is movable at 2 or more degrees of freedom, unlikein FIGS. 5 and 6.

Specifically, each bending segment 110 of FIGS. 7A and 7B includes apair of connecting parts 120 on one side of the length and a pair ofrecess parts 121 on the other side. The pair of connecting parts 120face each other with respect to the center of the bending segment 110,and the pair of recess parts 120 also do likewise. As is the case inFIG. 6A, the connecting parts 120 each consist of a protrusion with around surface, and the recess parts 121 are configured to be rotatableand accommodate the connecting parts.

As illustrated in FIG. 7B, in each bending segment 110, a shaft thatjoins the pair of connecting parts 120 and a shaft that runs between thepair of recess parts 121 are orthogonal to each other. That is, the pairof connecting parts and the pair of recess parts are positioned atdifferent locations with respect to a cross-section of the bendingsegment 110 (more specifically, the pair of connecting parts and thepair of recess parts intersect at 90 degrees around the body).

Hence, the bending segment 110 moves hingedly with respect to anadjacent segment on one side on a first shaft h1 and with respect to anadjacent segment on the other side on a second shaft h2. That is, theconnecting parts of the bending segments are configured in such a waythat the first hinge shaft and the second hinge shaft are arranged in analternating fashion. Accordingly, the bending segments of FIG. 7 maymove at 2 degrees of freedom.

Each bending segment comprises four lumens that are formed along thelength. As illustrated in FIG. 7B, each lumen 112 is arranged topenetrate a connecting part 120 or a recess part 121. Accordingly, thefour lumens are positioned at locations where the connecting parts andthe recess parts are formed, spaced at 90-degree intervals around thebody.

Four bending actuation wires 400 are located in the four lumens 112,respectively. Among them, one pair of wires induces bending of one shaftof the steerable member, and the other pair of wires induces bending ofthe other shaft.

Each lumen is partially open, as is with the aforementioned example. Asillustrated in FIG. 7A, a portion of each lumen 112 along the lengthwhere a connecting part 120 or recess part 121 is formed forms a closedlumen portion 112 b, and the other portion where the connecting part 120or recess part 121 is not formed forms an open lumen portion 112 a.Needlessly to say, the closed lumen portion may be centered on eachlumen, and the open lumen portion may be positioned on either side ofthe closed lumen portion. Nevertheless, the configuration shown in FIG.7 offers the advantage of further reducing the length of the slack.

Besides, although FIG. 7B illustrates that the lumen 112 penetrates theconnecting part 120 or recess part 121, the lumen 112 may be divertedfrom the connecting part 120 and the recess part 121. Specifically, theconnecting parts 120 and the recess parts 121 may be spaced at 90-degreeintervals around the lateral side of the body (e.g., along thecircumference) of the bending segment 110. Each lumen 112 may be locatedbetween the connecting part 120 and the recess part 121, especially at apoint where it is at 45 degrees to the connecting part 120 and therecess part 121.

In this case, as illustrated in FIGS. 8A and 8B, each lumen 112 may beconfigured in such a way that a closed lumen portion 112 b is formed atthe middle of the length of the lumen and an open lumen portion 112 a isformed on either side of the closed lumen portion 112 b.

FIGS. 7 and 8 have been explained with respect to a connecting part 120consisting of a protrusion with a round surface and a recess part 121accommodating the connecting part 120. However, this is merely anexample, and as shown in FIG. 6B, the connecting part may consist of aprotrusion with a linear edge and the recess part may have a v-shapednotch-like groove (see FIGS. 9A and 9B). Otherwise, as shown in FIGS. 5Aand 5B, two connecting parts may be pinned together in a way that allowshinge movement, rather than each comprising the connecting part and therecess part.

The exemplary embodiments shown in FIGS. 7 to 9 involve a connectingstructure for rotation with respect to one shaft, in which a pair ofconnecting parts is provided at one bending segment and a pair of recessparts is provided at another bending segment. Besides, one connectingpart and one recess part may be located on one end of one bendingsegment to face each other with a hollow body between them, and theconnecting part and recess part of an adjacent bending segment may belocated the other way round, taking into account the layout of theconnecting part and recess part of the bending segment connected to theadjacent bending segment.

FIG. 10 is a view illustrating a steerable member using a flexible hingestructure. As illustrated in FIG. 10, the bending segments 110 are inthe shape of a disc-like plate, and connected by flexible connectingparts 120 situated between the bending segments 110. While the steerablemember of FIGS. 5 to 9 can be bent using a mechanical hinge structure ofthe connecting parts, the steerable member of FIG. 10 can be bent usingthe elasticity of the material of the connecting parts.

More specifically, the steerable member of FIG. 10 consists of aplurality of bending segments 110 formed integrally with one another anda plurality of connecting parts 120. For example, it may be manufacturedby a molding method using plastic resin with flexibility. As illustratedin FIG. 10, each bending segment 110 and each connecting part 120 have ahollow channel 111 inside them. The connecting parts 120 are providedbetween each bending segment 110, and have a wall structure that extendsin an outer radial direction from two opposite sides of the hollowchannel. A connecting part 120 (wall structure) is arranged in adirection perpendicular to the direction in which an adjacent connectingpart is arranged. Accordingly, the steerable member of FIG. 10 may bendat 2 degrees of freedom.

Four lumens 112 where bending actuation wires 400 are located arearranged at 90-degree intervals. Each lumen 112 is formed at a pointwhere it penetrates the outer edge of a connecting part 120. In thisinstance, as in the foregoing exemplary embodiment, each lumen 112 is apartially open lumen portion 112. As illustrated in FIG. 5B, the closedlumen portion 112 b of each lumen is formed at a point where itpenetrates the connecting part and the open lumen portion 112 a thereofis formed on either side of the closed lumen portion 112 b where thebending segment is penetrated. Accordingly, the steerable member 100 ofthis exemplary embodiment may bend on the connecting parts 120 as thebending actuation wires 400 move.

FIG. 11 is a view illustrating a steerable member using a flexiblebackbone structure. The steerable member 100 of FIG. 11 comprisesbending segments 110 each consisting of a disc-like plate and connectingparts 120 using a backbone structure for connecting the centers of thebending segments. The connecting parts 120 may consist of individualmembers provided between each bending segment, or may consist of asingle member that penetrates through a plurality of bending segments.In this case, the connecting parts 120 may comprise a flexible material,and may bend when the bending actuation wires 400 move.

The steerable member of FIG. 10 also includes four lumens 112, and eachlumen is partially open. Specifically, the lumen 112 may include aclosed lumen portion 112 b formed at the middle part of the length ofthe lumen and an open lumen portion 112 a formed on either side of theclosed lumen portion 112 b.

In the exemplary embodiments set forth above, bending segments capableof minimizing slack are used to prevent backlash caused by bending. Thesteerable member may be configured in other various ways in order toprevent backlash.

FIGS. 12 to 14 are views illustrating a steerable member with a lateralsupporting member 130. The lateral supporting member 130 comprises anelastic material or super-elastic material, and exerts a restorationforce for returning to the original shape when its shape is deformed.That is, this steerable member may include at least one lateralsupporting member within it, and may be configured to restore theelasticity of the lateral supporting member to the initial position whenit is bent.

FIGS. 12A to 12C are views illustrating bending properties provided by alateral supporting member. As illustrated in FIG. 12, if at least onebending actuation wire 400 is pulled by manipulating the manipulatingpart, the steerable member 100 bends in the corresponding direction. Inthis case, the steerable member 100 comprises at least one lateralsupporting member 130, and the bending actuation wire 400 is manipulatedto cause bending by overcoming the elasticity of the lateral supportingmember 130 (FIG. 12B). Afterwards, when the corresponding bendingactuation wire is released from being pulled (FIG. 12C), the steerablemember 100 returns to neutral by the elasticity of the lateralsupporting member 130.

Conventionally, while the bending actuation wire on one side ismanipulated to bend in one direction, the bending actuation wire on theother side is manipulated to return to neutral. Accordingly, a slackoccurs due to the bending, causing backlash. However, with the use ofthe lateral supporting member as shown in FIGS. 12A to 12C, the backlashcaused by the slack in the bending actuation wire may not be a problemduring the bending.

FIGS. 13A to 13E are views illustrating various exemplary embodiments ofa steerable member using lateral supporting members. As illustrated inFIGS. 13A to 13E, the steerable member 100 may comprise a plurality ofbending actuation wires 400 and a plurality of lateral supportingmembers 130. The lateral supporting members 130 may be configured invarious types of structures, such as a wire structure or a hollow tubestructure, that can function as lateral springs. The bending segments110 of the steerable member 100 are configured to bend at 2 degrees offreedom, and may comprise a plurality of lumens 112 for allowing thebending actuation wires 400 and the lateral supporting members 130 topass through them along the wall surface of the body.

In FIGS. 13A to 13C, a plurality of bending actuation wires 400 and aplurality of lateral supporting members 130 are placed separately. InFIGS. 13A and 13B, four bending actuation wires 400 are arranged at90-degree intervals around the body of the bending segments 110, andfour lateral supporting members 130 are arranged at 45-degree intervalsbetween each bending actuation wire 400. In this case, as shown in FIG.13A, the four bending actuation wires 400 may be arranged to passthrough the connecting parts 120 of the bending segments, and as shownin FIG. 13B, the four lateral supporting members 130 may be arranged topass through the connecting parts 120 of the bending segments 110.Alternatively, as shown in FIG. 13C, a bending actuation wire 400 and alateral supporting member 130 may be arranged as a pair between eachconnecting part location along the circumference, so as not to passthrough the connecting parts of the bending segments 110.

In FIGS. 13D and 13E, the lateral supporting members 130 have a hollowtube structure, and the bending actuation wires 400 are located insidethe lateral supporting members 130, respectively. The lateral supportingmembers 130 and the bending actuation wires 400 may be arranged at90-degree intervals around the body of the bending segments 110. In FIG.13D, the lateral supporting members 130 and the bending actuation wires400 are arranged to pass through the connecting parts of the bendingsegments. In FIG. 13E, the lateral supporting members 130 and thebending actuation wires 400 are located between each connecting partlocation so as not to pass through the connecting parts.

FIGS. 14A to 14C are views illustrating bending properties provided by apre-shaped lateral supporting member. The lateral supporting members ofFIGS. 12 and 13 have a shape corresponding to the neutral position ofthe steerable member. Accordingly, the steerable member is configured tobe bent with the bending actuation wires and to return to neutral by thelateral supporting members. In contrast, the lateral supporting member130 of FIG. 14 is configured to have a bent shape in one direction sothat the elasticity of the lateral supporting member 130 contributes tobending of the steerable member to one side.

In an example, the lateral supporting member 130 of FIGS. 14A to 14C ispre-shaped to bend to the left. The steerable member with the lateralsupporting member 130 in it remains bent to the left without anymanipulation using the bending actuation wire (FIG. 14A). Also, if thebending actuation wire 400 moves by a first tensile force F, thesteerable member can be placed in the neutral position (FIG. 14B). Thefirst tensile force is large enough to be in equilibrium with a momentcreated by the elasticity of the lateral supporting member 130. If thebending actuation wire 400 moves by a second tensile force F′, which islarger than the first tensile force, the steerable member can bend tothe right (FIG. 14C). In this case, if the tensile force exerted on thebending actuation wire 400 is released by the first tensile force, thesteerable member can move to neutral (FIG. 14B), or if the tensile forceexerted on the bending actuation wires is completely released, thesteerable member can bend to the left (FIG. 14A).

In this instance, the steerable member moves to the neutral position orthe initial position by the elasticity of the lateral supporting member,thereby enabling bending control without backlash. Although FIG. 14depicts a bending mechanism that has 1 degree of freedom using apre-shaped lateral supporting member and bending actuation wires, avariety of bending mechanisms using a pre-shaped lateral supportingmember may be used.

In addition, a bending mechanism using connecting segments that causesno backlash, as well as the above-mentioned method using a lateralsupporting member, may be used, as shown in FIGS. 15 to 17.

FIGS. 15A and 15B are views illustrating a wire path difference causedby bending of bending segments connected by connecting segments. In theforegoing exemplary embodiment (e.g., in FIGS. 3 to 9), each bendingsegment 110 may be coupled directly to adjacent bending segments by theconnecting parts 120 provided in the body, and rotate relative to onehinge shaft shared between each pair of adjacent bending segments. Incontrast, as shown in FIG. 15, a connecting segment 140 is providedbetween each pair of adjacent bending segments 110, and two adjacentbending segments are connected to two ends of the connecting segment140, respectively. The connecting segment 140 has a double hinge jointstructure that enables two points on the connecting segment 140 to behinged to two different members. Accordingly, a pair of adjacent bendingsegments 110 is coupled to two ends of the connecting segments,respectively, so as to rotate relative to different hinge shafts,without sharing a hinge shaft.

Let the distance between the wires on either side of a bending segment110 be 2r and let the distance between two hinge shafts of theconnecting segment be L. The bending segment 110 may be hinged to theconnecting segment 140, at a point midway between a pair of wires (i.e.,at a distance of r from each wire).

FIG. 15A illustrates the adjacent bending segment before bending, andFIG. 15B illustrates the adjacent bending segment when bent to a radiusof curvature R. In B of FIG. 15, the angle of bend between two bendingsegments 110 is denoted by θ. Also, it can be assumed that the angleseprox and edistal of bend between the bending segments and theconnecting segment created by bending are equal. In this case, thefollowing equation is to compare the sum of the lengths of two wireportions between the two bending segments before bending and the sum ofthe lengths of the two wire portions after bending. The lengths of thetwo wire portions before bending are denoted by L₁ and L₂, respectively,and the lengths of the two wire portions after bending are denoted byL₁′ and L₂′, respectively.

L₁ = L₂ = L$L_{1}^{\prime} = {2\left( {R + r} \right){\sin\left( \frac{\theta}{2} \right)}}$$L = {2R\;{\sin\left( \frac{\theta}{2} \right)}}$$L_{2}^{\prime} = {2\left( {R - r} \right){\sin\left( \frac{\theta}{2} \right)}}$${L_{1} + L_{2}} = {{2L} = {4R\;{\sin\left( \frac{\theta}{2} \right)}}}$${L_{1}^{\prime} + L_{2}^{\prime}} = {{{2\left( {R + r} \right){\sin\left( \frac{\theta}{2} \right)}} + {2\left( {R - r} \right){\sin\left( \frac{\theta}{2} \right)}}} = {4R\;{\sin\left( \frac{\theta}{2} \right)}}}$L₁ + L₂ = L₁^(′) + L₂^(′)

That is, if the steerable member 100 connected by the connecting segment140 is bent, the sum (L₁+L₂) of the lengths of the two wire portionsbefore bending and the sum (L₁′+L₂′) of the lengths of the two wireportions after bending are substantially equal. Accordingly, any slackcaused by bending can be prevented.

Needless to say, FIGS. 15A and B assumes that the angles eprox andedistal of bend between the bending segments 140 and the connectingsegment 110 are equal because bending occurs at each bending segment dueto the same wire. However, when actual bending occurs, the angles ofbend between the connecting segment 140 and the bending segments 110 arewithin a substantially similar range although they are slightlydifferent. Thus, the length of slack can be minimized as compared to thestructure in which two bending segments are coupled together on a singlehinge shaft.

FIGS. 16A and B are perspective views illustrating a connecting segmentand bending segments connected by the connecting segment. FIGS. 17A andB are perspective views illustrating a steerable member comprisingconnecting segments.

As illustrated in FIG. 16A, a connecting segment 140 is hinged to afirst bending segment 110 a and a second bending segment 110 b atdifferent points. The connecting segment 140 comprises two bodies 141facing each other. Each body 141 includes a first hinge part 142 a onone end of its length and a second hinge part 142 b on the other end(see FIG. 16B). The first and second bending segments 110 a and 110 bare coupled to the first and second hinge parts 142 a and 142 b,respectively, so that they move hingedly on different hinge shafts.

In FIG. 16, the first hinge part 142 a and the second hinge part 142 beach consist of a protrusion with a round surface, and are accommodatedin recess parts 121 b formed in the bending segments 110 and movehingedly. However, this is merely an example, and at least one of thefirst and second hinge parts may be a recess part for accommodating theprotrusion or may be connected by other hinge structures such aspinning.

The connecting segment 140 further comprises a guide member 143 with ahollow space inside it that joins together the two bodies 141 facingeach other. Due to this, the connecting segment 130 may form a module.The hollow space of the guide member 143 allows various kinds of wiremembers such as the bending actuation wires or the effector actuationwire to pass through, and prevents internal components from falling outduring bending. A cross-section of the guide member 143 may be similarto a cross-section of the bending segments. In this case, portionsthrough which the bending actuation wires pass may be open so as not torestrict the movement of the bending actuation wires.

The steerable member of FIGS. 17A and 17B comprises a plurality ofconnecting segments 140, and adjacent connecting segments 140 areconfigured to have hinge shafts orthogonal to each other. Each bendingsegment 110 has four lumens 112 so that four bending actuation wires 400are respectively located in them. Therefore, the steerable member 100can bend at 2 degrees of freedom (see FIG. 17B). In this case, thebending actuation wires 400 may be located between each hinge shaftlocation around the body of the bending segments 110 so as not to passthrough the hinge shafts of the connecting segments 140.

In another exemplary embodiment, FIGS. 18A and 18B are viewsschematically illustrating a slack in a wire that forms a curved pathdue to bending of the steerable member. While FIGS. 3A and 3B depict awire that forms a bent straight-line path when bending occurs, FIGS. 18Aand 18B depict a wire that forms a curved path when bending occurs. Ifthe lengths of two wire portions before bending are denoted by L1 andL2, respectively, and the lengths of the two wire portions after bendingare denoted by L1′ and L2′, respectively, the relationship between thelengths of the two wire portions is as follows:

$\mspace{79mu}{{L_{1} + L_{2}} = {4R\;{\tan\left( \frac{\theta}{2} \right)}}}$     L₁^(′) + L₂^(′) = (R + r)θ + (R − r)θ = 2R θ${\Delta\; L_{slack}} = {{\left( {L_{1} + L_{2}} \right) - \left( {L_{1}^{\prime} + L_{2}^{\prime}} \right)} = {{4{R\left( {{\tan\left( \frac{\theta}{2} \right)} - \frac{\theta}{2}} \right)}} > {0\left\lbrack {{{\Delta\; L_{slack}} < {\Delta\; L_{{Fig}\; 3}}} = {4{R\left( {{\tan\left( {\theta/2} \right)} - {\sin\left( {\theta/2} \right)}} \right)}}} \right\rbrack}}}$

As compared with the wire of FIG. 3 that forms a bent straight-line pathwhen bending occurs, the wire of FIG. 18B that forms a curved path canhave an approximately 30% reduction in the length of the slack. Usingthis principle, the bending actuation wires are configured to form acurved path when bending occurs by including a path adjusting member,thereby minimizing the slack.

FIGS. 19A and 19B are views illustrating a steerable member using a pathadjusting member. As illustrated in FIG. 19A, the steerable member 100comprises plate-like bending segments 110 and wall-like connecting parts120 located between the bending segments. Also, four lumens 112 areformed to penetrate the outer edges of the bending segments 100 andconnecting parts 120 (refer to the description of FIG. 10).

As illustrated in FIG. 19B, bending actuation wires 400 are locatedinside the path adjusting member 150 in each lumen, rather than beinglocated directly in each lumen. The path adjusting member 150 comprisesan elastic material such as metal, and bends when the steerable member100 is bent, thereby forming a curved wire path (in this case, theelasticity of the path adjusting member does not need to be high enoughto produce a restoration force as shown in FIGS. 13D and 13E, and anelastic force sufficient to form a curved path will do). Accordingly,the bending actuation wires 400 according to this exemplary embodimentbend not along a bent straight-line path but along a curved path,thereby minimizing the length of the slack.

While this exemplary embodiment has been described with respect to anexample in which the path adjusting member is used for the steerablemember using a flexible hinge structure, modifications may be made, likeplacing wires in the steerable member shown in FIGS. 11 to 17 with theuse of the path adjusting member.

FIGS. 20A and 20B are views illustrating bending of the steerablemember. As illustrated in FIG. 20A, at the initial stage of the bending,the bending is not uniform across the entire steerable member 100, butit is concentrated at the distal end of the steerable member where thebending actuation wire 300 ends (see FIG. 20B). Thus, a force istransmitted directly to the distal end of the steerable member when thewire moves, causing the steerable member to bend less at the proximalend.

FIGS. 21A to 21C are cross-sectional views of a steerable memberaccording to one exemplary embodiment of the present invention. FIGS.21A to C depict different embodiments for improving the concentration ofbending at the distal end of the steerable member, which involves ageometrically enhanced structure in which the steerable member bendsmore easily at the distal end than at the proximal end.

Specifically, as shown in FIG. 21A, the bending segments 110 have lumensformed at a distance from the center of a cross-section of the steerablemember, and the closer to the proximal end of the steerable member, themore distant the lumens in the bending segments get from the center ofthe cross-section of the steerable member. In this case, the momentapplied to the steerable member 100 is smaller at the distal end andincreases towards the proximal end. Thus, the steerable member 100 bendsmore easily toward the proximal end.

FIG. 21B, the connecting parts 120 may be configured to gradually changein shape along the length of the steerable member 100 such that thesteerable member bends more easily at the proximal end than at thedistal end. In an example, as illustrated in FIG. 21B, the bendingproperties along the length can be adjusted by configuring theconnecting parts to have a larger sectional width at the distal end thanat the proximal end. Alternatively, apart from adjusting the width ofthe connecting parts, the connecting parts may be configured in othervarious ways of shape variation, including adjusting the range ofmovement of connecting parts having a joint structure.

Also, as shown in FIG. 21C, the distance between the bending segments110 may change along the length. Specifically, the connecting parts 120may be positioned such that the distance between the bending segmentsgets shorter toward the distal end and longer toward the proximal end.In this case, the longer the distance between the bending segments, theeasier the bending of the steerable member. This results in restrictionof the bending near the distal end and improvement in the bendingproperties near the proximal end.

The steerable member of this configuration has a plurality of bendingactuation wires located along the lumens, and the distal end of eachbending actuation wire is fixed by a wire termination member 410provided at the distal end of the steerable member.

FIGS. 22A to 22C are views illustrating a method of fixing bendingactuation wires by a wire termination member. As the steerable memberand the bending actuation wires are very small in size, fixingindividual bending actuation wires to the distal end of the steerablemember is highly difficult. Accordingly, this exemplary embodiment usesa wire termination member capable of easily fixing a plurality ofbending actuation wires.

As illustrated in FIG. 22A, the wire termination member 410 has a thread411 on one side, and is screwed to the distal end of the steerablemember 100. Also, the wire termination member includes a plurality ofholes 412 through which a plurality of bending actuation wires pass, andthe holes 412 are formed at locations corresponding to the lumens in thesteerable member. Accordingly, the wire termination member can bescrewed to the distal end of the steerable member while the bendingactuation wires 400 are inserted in the holes of the wire terminationmember (FIG. 22B), thereby making it easy to fix the bending actuationwires (FIG. 22C).

The wire termination member may be a component that is provided betweenthe steerable member and the end effector. In this case, the wiretermination member may be screwed to the distal end of the steerablemember, and the end effector may be connected to the wire terminationmember. Alternatively, as illustrated in FIG. 23, the end effector 300may be used as the wire termination member by fixing the bendingactuation wires 400 to the inside of the end effector 300 and screwingthe end effector 300 directly to the distal end of the steerable member100.

Although FIGS. 22A to 22C have been described with respect to asteerable member having the structure shown in FIG. 10, it is needlessto say that the bending actuation wires can be likewise fixed even ifthe steerable member has other structures.

In the above discussion, various exemplary embodiments of the steerablemember have been described with reference to FIGS. 5 to 22. Thesteerable member is described as a component of the surgical apparatusthat has an end effector, but the present invention is not limitedthereto. For example, the present invention is applicable to bendablesteerable members for various kinds of surgical instruments, such as animaging unit or a lumen unit with a working channel.

Referring back to FIG. 2, the end effector 300 is provided at the distalend of the steerable member. As described above, the end effector 300may be coupled directly to the distal end of the steerable member 100 orcoupled to it through a component such as the wire termination member.The end effector 300 comprises various types of surgical elements 311for use in surgery. FIG. 2 illustrates an end effector comprising aforceps by way of example.

The proximal end of the end effector 300 is connected to the effectoractuation wire 500. The effector actuation wire 500 is located in thechannels 111 of the steerable member 100, and mechanically connected tothe manipulating part 10 through the steerable member 100 and theflexible member 200. Accordingly, the effector actuation wire 500actuates the end effector 300 as it moves lengthwise by the manipulatingpart 10.

FIGS. 24A to 24B are cross-sectional views schematically illustratingthe operating principle of the end effector. The end effector 300operates in a first mode when the effector actuation wire 500 is pulledin the direction of the manipulating part 10 (FIG. 24A), and operates ina second mode when the effector actuation wire 500 is pulled in thedirection of the end effector 300 (FIG. 24B). The first mode involvesclosing the forceps of the end effector, and the second mode involvesopening the forceps. The action of pulling the effector actuation wire500 in the direction of the manipulating part may be done easily by thedriving part of the manipulating part, thereby transmitting the force tothe end effector. On the other hand, the action of bringing the effectoractuation wire 500 back in the direction of the end effector 300 may notbe done properly by the driving part 400 because the effector actuationwire has a wire structure. Accordingly, in this exemplary embodiment,the end effector 400 may include an elastic body 341 to perform a secondmode operation by pulling the effector actuation wire 500 using theelasticity of the elastic body 341.

Specifically, as illustrated in FIG. 24, an effector module of the endeffector comprises an instrument portion 310 for performing a surgicaloperation and an actuation portion 320 for actuating the instrumentportion 310. The instrument portion 310 is linked to the actuationportion 320, and configured such that the surgical elements 311 areopened or closed on both sides by the movement of the actuation portion320 while a joint 330 of the instrument portion 310 is fixed. Theelastic body 341 may be located at the proximal end of the actuationportion. When the effector actuation wire 500 is pulled by themanipulating part 10, the actuation portion 320 moves backward whilepushing the elastic body 341 and the surgical elements 311 are thereforeclosed (FIG. 24A). Also, when the force acting on the effector actuationwire 500 is released by the manipulating part 10, the restoration forceof the elastic body 341 causes the actuation portion 320 to move in thedirection of the instrument portion 310, thereby opening the surgicalelements 311 (FIG. 24B). In this way, the operative mechanism of the endeffector can be simplified with the use of the elastic body.

The structure of the end effector using the elastic body may be designedin various ways. FIG. 25 is a view illustrating an example of such anend effector. As illustrated in FIG. 25, the end effector 300 maycomprise an effector module 301 and a body portion 340 where theeffector module 301 is mounted. The instrument portion 310 of theeffector module 301 is configured to be exposed to the distal end of thebody portion 340, and the actuation portion 320 thereof is accommodatedinside the body portion 340. A joint 330 connecting the instrumentportion 310 and the actuation portion 320 may be fixed at the bodyportion 340, and the actuation portion 320 may reciprocate inside thebody portion 340. The elastic body 341 provided inside the body portion340 is located behind the actuation portion 320, and the proximal end ofthe actuation portion 320 is connected to the effector actuation wire500. Accordingly, the instrument portion 310 may be manipulated bymoving the actuation portion 320 with the effector actuation wire 500and the elastic body 341.

Also, all or part of the end effector 300 may be detachably connected tothe distal end of the steerable member 100. Accordingly, a variety ofinstruments needed for surgery may be selectively fastened and used. Inan example, the end effector 300 of FIG. 25 is configured such that theeffector module 301 is attachable to or detachable from the distal endof the effector actuation wire 500. The effector module 301 and thedistal end of the effector actuation wire 500 may be detachably fastenedin various ways; for example, they may be magnetically fastened togetheraccording to the exemplary embodiment illustrated in FIG. 25.Accordingly, at least either the proximal end of the actuation portion320 or the distal end of the effector actuation wire 500 consists of amagnetic body, which enables the fastening.

As described above, a surgical instrument according to this exemplaryembodiment comprises a bendable steerable member 100 and an operable endeffector 300. Also, the steerable member 100 and the end effector 300are moved by a plurality of wire members such as the bending actuationwires 400 and the effector actuation wire 500. These wire members arearranged to pass through the steerable member 100 and the flexiblemember 200. Accordingly, if the wire members are linearly arranged sothat each of them has the shortest path, the movement of the wires maybe restricted or affected by the bending of the steerable member orflexing of the flexible member. Therefore, in this exemplary embodiment,at least one sleeve forming a path of travel of a wire member may beprovided inside the steerable member or the flexible member. This sleeveis longer than the maximum length of the portion where the sleeve isprovided (for example, the length of that portion when bent or flexed),so the wire members have a long enough path even when the steerablemember is bent or the flexible member is flexed.

FIG. 26A is a cross-sectional view illustrating a path of travel of theeffector actuation wire. As illustrated in FIG. 26A, one end of theeffector actuation wire 500 is mounted at the proximal end of the endeffector 300, and the other end is mechanically connected to themanipulating part 10 (FIG. 1). One end of a sleeve 600 forming a path ofthe effector actuation wire 500 is fixed in place at the distal end ofthe steerable member 100 or the proximal end of the end effector 300.Also, the other end is fixed in place at the proximal end of theflexible member 200. In this instance, the sleeve 600 is longer than thelength of the portion where two ends of the sleeve are fixed (the sum ofthe length of the steerable member and the length of the flexiblemember). This extra length added to the sleeve (FIG. 26B) gives moreroom for the path of the effector actuation wire 500 even when thesteerable member 100 is bent (FIG. 26C). Accordingly, the movement ofthe end effector 300 may be decoupled from the bending movement of thesteerable member 100 to prevent its movement from being affected by thebending movement of the steerable member 100.

FIG. 27A is a view illustrating a path of travel of the bendingactuation wire. As illustrated in FIG. 27A, a sleeve 600 for securingthe path of the bending actuation wire 400 may be provided. In thiscase, one end of the sleeve 600 is fixed at the proximal end of thesteerable member 100 or the distal end of the flexible member 200, andthe other end is fixed at the proximal end of the flexible member 200(see FIGS. 27B and 27C). The sleeve 600 is configured to have an extralength added to the linear length of the portion where the sleeve isplaced. Accordingly, the bending of the steerable member 100 will not beaffected by the flexing of the flexible member 200.

FIGS. 28 and 29 are views illustrating a path of travel of a bendingactuation wire 400 with two bendable portions. While the previousdrawings illustrate a structure in which the steerable member 100 hasone bending portion, the steerable member 100 may be divided into adistal end steerable portion 101 and a proximal end of steerable portion102, which can bend separately. In this case, the distal end steerableportion 101 is bent with a distal end bending actuation wire 401, andthe proximal end steerable portion 102 is bent with a proximal endbending actuation wire 402. One end of the distal end bending actuationwire 401 is fixed at the distal end of the distal end steerable portion101, passes through the lumens in the distal end steerable portion 101,and then extends to the manipulating part 10 through hollow channels ofthe steerable member 100 and flexible member 200. Also, one end of theproximal end bending actuation wire 402 is fixed at the distal end ofthe proximal end steerable portion 102, passes through the lumens in theproximal end steerable portion 102, and then extends to the manipulatingpart 10 through hollow channels of the flexible member 200. In thisinstance, two distal end bending actuation wires 401 and two proximalend bending actuation wires 402 may be provided and have 1 degree offreedom in each bending portion, or four distal end bending actuationwires 401 and four proximal end bending actuation wires 402 may beprovided and have 2 degrees of freedom in each bending portion.

As illustrated in FIG. 28A, a sleeve 600 for securing a path of thedistal end bending actuation wire 401 may be provided. One end of thissleeve 600 may be fixed at the proximal end of the distal end steerableportion 101, and the other end may be fixed at the proximal end of theflexible member 200 (see FIGS. 28B and 28C). Also, as illustrated inFIG. 29A, a sleeve 600 for securing a path of the proximal end bendingactuation wire 402 may be provided. One end of this sleeve 600 may befixed at the proximal end of the proximal end steerable portion 102, andthe other end may be fixed at the proximal end of the flexible member200 (see FIGS. 29B and 29C). As is the case with the above-mentionedsleeves, each sleeve 600 has an extra length, so the bending movement ofeach bending portion can be decoupled.

As described above, the sleeves 600 explained with reference to FIGS. 26to 28 have an extra length added to the length of the portion where theyare placed, and they may comprise an elastic material, allowing theirshape to change along with the movement of the components. Such a sleevestructure allows decoupling of the movement of each component from themovement of the others, and prevents wire members in narrow channelsfrom being twisted or damaged by friction.

FIG. 30 is a view illustrating a connecting structure of the end of asurgical instrument and the manipulating part. As explained above, thesurgical instruments 30 are respectively located in passages in theinsertion part 20, and the end of a surgical instrument is mechanicallyconnected to the manipulating part 10. The manipulating part 10comprises transmission members 700 corresponding to a plurality of wiremembers W of the surgical instrument and couplers 701 to be fastened towires. The wire members W of the surgical instrument each include aproximal end module M at the proximal end, and each proximal end moduleM is fastened to the corresponding coupler 701. Thus, each wire membercan be moved by each driving part in the manipulating part.

In this case, the insertion part 20 and the manipulating part 10 areattachable to or detachable from each other, and the surgical instrument30 provided in the insertion part 20, too, is attachable to ordetachable from the manipulating part 20. This means that the insertionpart or the surgical instrument can be cleaned or replaced with newones. The surgical instrument 30 and the manipulating part 10 may bedetachably fastened in various ways; for example, they may bemagnetically fastened together, as shown in FIG. 30. Accordingly, theproximal end of the surgical instrument (specifically, the proximal endmodules of the bending actuation wires and effector actuation wire) orthe distal end of the manipulating part (specifically, the couplers ofthe transmission members) may be consist of a magnetic body and beattached to or detached from each other by magnetic force.

FIGS. 31 and 32 schematically illustrate the configuration of themanipulating part 10 for moving the bending actuation wires 400. Thewire members W of the above-described surgical instrument aremechanically connected to the driving part 40 of the manipulating part10 and move linearly along with the movement of the driving part 40. Thedriving part may be constructed using various devices such as anactuator, a linear motor, a motor, etc. Also, each wire member may beconnected to different driving parts so that they can move separately.

In this instance, a pair of bending actuation wires 400 located facingeach other within the steerable member 100 move in opposite directionswhen bending occurs. Specifically, when bending occurs, the bendingactuation wire near the center of curvature has a shorter path and thebending actuation wire on the other side of the center of curvature hasa longer path. Accordingly, the pair of wires facing each other may movesimultaneously in opposite directions with the use of a single drivingpart 40. In this case, the manipulating part can be designed to becompact by reducing the number of driving parts.

In FIGS. 31A and 31B, the manipulating part comprises a screw member 41and a driving part 40 for rotating the screw member 41. The screw member41 may be a bi-directional lead screw, which means that two threadportions having different orientations are formed on a single screwmember. Accordingly, the coupler of a transmission member to beconnected to a first bending actuation wire 403 is coupled to a firstthread 41 a, and the coupler of a transmission member to be connected toa second bending actuation wire 404 is coupled to a second thread 41 b.Accordingly, as the driving part rotates, the first bending actuationwire 403 and the second bending actuation wire 404 move respectively acorresponding distance, in opposite directions on a straight line,thereby causing the steerable member to bend. Also, the directions ofmovement of the first bending actuation wire 403 and the second bendingactuation wire 404 may be reversed by changing the direction of rotationof the driving part, thus enabling them to bend in the reversedirection.

In FIG. 32, the manipulating part comprises a pair of screw members anda driving part 40 for rotating the screw members. The pair of screwmembers consists of a first lead screw 42 with a first thread and asecond lead screw 43 with a second thread oriented in the oppositedirection to the first thread. The first lead screw 42 and the secondlead screw 43 are connected to the driving part 40 by a gear 44 androtate in the same direction along with the rotation of the drivingpart. The first bending actuation wire 403 is mechanically connected tothe first lead screw 42, and the second bending actuation wire 404 ismechanically connected to the second lead screw 43. Accordingly, as isthe case in FIG. 31, when the motor rotates, the first and secondbending actuation wires may move in opposite directions, causing thesteerable member to bend.

Although FIGS. 31 and 32 depict the use of a screw member as an exampleto drive the bending actuation wires in a pair, it is needless to saythat modifications can be made using various link structures.

FIGS. 33A and 33B are views schematically illustrating the length of abending actuation wire before and after bending in an ideal continuousflexible arm. FIG. 33A shows the length of the bending actuation wirebefore bending in an ideal continuous flexible arm, while FIG. 33B showsthe length of the bending actuation wire after bending in an idealcontinuous flexible arm being pulled with a wire-driven mechanism A(e.g. a pulley).

In an ideal continuous flexible arm, let a bending actuation wire belocated on two opposite sides of the wire-driven mechanism A having awidth of 2r, wherein “r” indicates a radius of the wire-driven mechanismA; “L₁” and “L₂” respectively indicate the length of the bendingactuation wire from both opposite sides of the wire-driven mechanism Ato the bending segment (not shown) before bending; “L₁′” and “L₂′”respectively indicate the length of the bending actuation wire from bothopposite sides of the wire-driven mechanism A to the bending segment(not shown) after bending; “L” indicates the length from the center ofthe wire-driven mechanism A to the bending segment; “R” indicates aradius of curvature when the wire-driven mechanism A is pulled as anarrow pointed to, and the angle of bend by the wire-driven mechanism Ais denoted by “8”.

In the ideal continuous flexible arm shown in FIGS. 33A and 33B, thetotal length of the bending actuation wire before and after bending canbe represented as the following equation:

before bending: L ₁ +L ₂=2Rθ;

after bending: L ₁ ′+L ₂′=(R+r)θ+(R−r)θ=2Rθ;

L ₁ +L ₂ =L ₁ ′+L ₂′.

However, as shown in FIGS. 34A and 34B which are view schematicallyillustrating the length of a bending actuation wire before (shown inFIG. 34A) and after bending (shown in FIG. 34B) in the actual condition.As FIG. 34B illustrated, the bending actuation wire is elongated bybeing pulled (indicated as ΔL elongation), resulting in slack B on thereleased wire, which causes backlash. In this condition, the totallength of the length of the bending actuation wires before and afterbending can be represented as the following equation:

before bending: L ₁ +L ₂=2Rθ;

after bending: L ₁ ′+L ₂ ′+ΔL elongation=(R+r)θ+(R−r)θ+ΔL elongation=2Rθ+ΔL elongation;

L ₁ +L ₂ ≠L ₁ ′+L ₂ ′+ΔL elongation.

In contrast, in this exemplary embodiment, the bending segment may beconfigured to comprise a series of intermediate joints havingtension-regulating members to minimize the slack caused by elongation.FIG. 35 is a view illustrating an exemplary bending segment according toan exemplary embodiment of the present invention. In FIG. 35, thebending segment 80 is illustrated to include four intermediate joints81, 82, 83, 84 arranged along a longitudinal axis direction of thebending segment. Each intermediate joint 81, 82, 83, 84 has a first linkportion 811, 821, 831 and 841 and a second link portion 812, 822, 832and 842, respectively. Each intermediate joint 81, 82, 83, 84 may beinterstacked orthogonally, in parallel or in any angle with the adjacentintermediate joint.

The bending segment 80 further comprises a plurality of lumens 801passing through each intermediate joint 81, 82, 83, 84. The same numberof bending actuation wires (being omitted for clarity) may be thuscorrespondingly provided to be arranged to pass through each lumen 801respectively and cause the bending segment 80 to bend.

Each intermediate joint 81, 82, 83, 84 further comprises twotension-regulating member 813, 823, 833 and 843 coupled to the firstlink portion 811, 821, 831 and 841 and the second link portion 812, 822,832 and 842. Each tension-regulating member 813, 823, 833 and 843 isconfigured to compensate for the elongation of the bending actuationwires when bending segments bend, whereby the length of bendingactuation wires is altered and kept in a predetermined length.

In FIG. 36, the tension-regulating member 813 is a double-hinged jointcomprising two off-axis hinge joints 814. Each off-axis hinge joint 814comprises a first interfacing half 815, 815′ coupled to the first linkportion 811 and a second interfacing half 816, 816′ coupled to thesecond link portion 812 and correspondingly pivoted to the firstinterfacing half 815, 815′. In this exemplary embodiment, each firstinterfacing half 815, 815′ may have a protrusion end, respectively,while the second interfacing half 816, 816′ correspondingly may have arecess end. In another exemplary embodiment, each first interfacing halfmay respectively have a recess end instead, while the second interfacinghalf correspondingly has a protrusion end.

Pivotal motion will occur on one of the two off-axis hinges 814depending on bending orientation. FIGS. 37A and 37B illustrates pivotalmotion of one of the tension-regulating member of FIG. 36, wherein FIG.37A is a front view of the tension-regulating member bending on the leftside, and FIG. 37B is a front view of the tension-regulating memberbending on the right side. As shown in FIG. 37A, the intermediate jointbends in a bending orientation on the left side on the left hinge 814which is offset from the longitudinal axis direction, whereby only firstinterfacing half 815 pivotally moves on the left side. Similarly, onlyfirst interfacing half 815′ pivotally moves on the right side whenintermediate joint 81 bends on the right side as shown in the FIG. 37B.

FIG. 38 is a view schematically illustrating a slack in a wire caused bywire elongation being minimized using the tension-regulating memberstructure in FIG. 36. FIG. 38 A shows the length of the bendingactuation wire before the tension-regulating member structure bends,while FIG. 38 B shows the length of the bending actuation wire after thetension-regulating member structure bends.

In FIGS. 38 A and B, “L” indicates respectively the height of the firstlink portion 811 or the second link portion 812 along a direction of thecentral axis of the intermediate joint 81. “L₁” indicates the length ofa bending actuation wire which passes through the lumen between the leftside of the first link portion 811 and the second link portion 812before bending, while “L₁′” indicates the length of the bendingactuation wire in the left side after bending. “L₂” indicates the lengthof a bending actuation wire which passes through the lumen between theright side of the first link portion 811 and the second link portion 812before bending, while “L₂′” indicates the length of the bendingactuation wire in the right side after bending. “r” indicates a radiusfrom the central axis of each link portion to the lumen that the bendingactuation wire passes through. “R” indicates a radius of curvature whenthe intermediate joint 81 bends and the angle of bend is denoted by “θ”.“d” herein indicates a distance from the central axis of each linkportion to each off-axis hinge joints 814.

As shown in FIGS. 38 A and B, if wire elongation is ignored in thisexemplary embodiment, the total length of the length of the bendingactuation wire before and after bending can be represented as thefollowing equation:

     L₁ = L₂ = L;     L₁^(′) = 2(R + r)sin (θ/2); L₂^(′) = 2(R − r)sin (θ/2);     L₁ = L₂ = L = L^(′) = 2(R − d)tan (θ/2);     L₁ + L₂ = 4(R − d)tan (θ/2);L₁^(′) + L₂^(′) = 2(R + r)sin (θ/2) + 2(R − r)sin (θ/2) = 4R sin (θ/2);     Herein, R = L/(2tan (θ/2)) + d;Δ L = (L 1 + L 2) − (L 1^(′) + L 2^(′)) = 2L − 4R sin (θ/2) = 2L − 4(L/(2tan (θ/2)) + d)(sin (θ/2).

FIG. 39 is a diagram of the simulation result illustrating the totallength change (ΔL) of the bending actuation wires as a function of thebending angle θ calculated using Matlab. For example, when, L=2, d=0.45,ΔL remains <0 when θ is within the range of motion of the designed joint(0 to 45 degrees); so the slack caused by wire elongation can becompensated by ΔL, made possible by off-axis hinge joints.

Thus, pivot motion of the intermediate joint 81 occurs on the hinge 814located offset from the longitudinal axis direction of the intermediatejoint 81. The length of bending actuation wires is altered and kept in apredetermined length in that the elongation of the bending actuationwires is compensated by the off-axis pivot motion.

FIG. 40 is a block diagram illustrating a surgical instrument accordingto an exemplary embodiment of the present invention. FIG. 41 is aschematic view illustrating a surgical instrument according to anexemplary embodiment of the present invention. As illustrated in FIG. 40and FIG. 41, a steerable member 100 that is bendable is provided at thedistal end of the surgical instrument 30. The steerable member 100 has aplurality of bending segments 110 with hollow channels (not shown inFIGS. 40 and 41) that are connected together. Each bending segment 110comprises a plurality of lumens 112 that are formed lengthwise. Aflexible member 200 comprising a flexible material is provided at theproximal end of the steerable member 100. The flexible member 200 maycomprise a hollow tube where various types of wire members connectedfrom the distal end of the surgical apparatus 1 are located. Optionally,an end effector 300 is provided at the distal end of the steerablemember 100, and the end effector 300 may be selectively actuated by aneffector actuation wire 500 (e.g. see FIGS. 2, 24-26).

Each bending segment 110 of the steerable member 100 is connected toadjacent bending segments in a way that allows hinge movement, and bentby a bending actuation wire 400 (see, e.g. FIG. 2). In this exemplaryembodiment, a first bending actuation wire 403 a and a second bendingactuation wire 403 b that are located in separate lumens 112 to passthrough the steerable member 100 and the flexible member 200, and thedistal ends of the first bending actuation wire 403 a and second bendingactuation wire 403 b are connected to the steerable member 100 and theirproximal ends are mechanically connected to a drive member 160.Accordingly, when the first bending actuation wire 403 a and secondbending actuation wire 403 b are moved by the drive member 160, theplurality of bending segments 110 move hingedly, thus causing 1-DOFbending motion of the steerable member 100.

The drive member 160 comprises a first motor 161, a second motor 162, afirst motion transmitting unit 163 and a second motion transmitting unit164. The first motor 161 is coupled to the first bending actuation wire403 a via a first motion transmitting unit 163, so that the power fromthe first motor 161 may be transmitted to the first bending actuationwire 403 a to make it actuate. Similarly, the second motor 162 iscoupled to the second bending actuation wire 403 b via a second motiontransmitting unit 164, transmitting the power from the second motor 162to actuate the second bending actuation wire 403 b. In this exemplaryembodiment, the first motion transmitting unit 163 and the second motiontransmitting unit 164 may be a lead screw or ball screw, but not limitedto this.

A tension monitoring member 170 is further provided, comprising: a firstsensor 171 and a second sensor 172. The first sensor 171 is coupled tothe first motion transmitting unit 163 and coupled to the first bendingactuation wire 403 a. The first sensor 171 may provide a first feedbacksignal 51 responsive to sensing change in tension force of the firstbending actuation wire 403 a between the pre-bending and the desiredbending motion. Similarly, a second sensor 172 is coupled to the secondmotion transmitting unit 164 and the second bending actuation wire 403b. The second sensor 172 may provide a second feedback signal S2responsive to sensing change in tension force of the second bendingactuation wire 403 b between the pre-bending and the desired bendingmotion. In this embodiment, the first sensor 171 and the second sensor172 are load cells, but not limited to this. The change in tension forceof the first bending actuation wire 403 a or the second bendingactuation wire 403 b provides an electrical value change (e.g. voltage,current or other parameters) that is calibrated to the load placed onthe load cell.

The drive member 160 and the tension monitoring member 170 as describedabove are further electrically connected to a control member 180. Thecontrol member 180 may provide a first output signal S3 responsive tothe first feedback signal S1 and transmit to the first motor. Uponreceiving the first output signal S3, the first motor 161 will be drivento adjust (i.e. pull or release) the first bending actuation wire 403 a.Similarly, the control member 180 may provide a second output signal S4responsive to the second feedback signal S2, and transmit to the secondmotor 162 to adjust the second bending actuation wire 403 b.

FIG. 42 is a view illustrating a surgical instrument in a bending statusaccording to an exemplary embodiment of the present invention. When thefirst bending actuation wire 403 a is actuated (i.e. pulled toward thedirection of the first motor 161 as shown in FIG. 42) in order to bendthe steerable member 100, tension of the first bending actuation wire403 a and/or the second bending actuation wire 403 b changes because ofvarious reasons. For example, change in the length between before andafter bending along the bending direction of the second bendingactuation wire 403 b is smaller that of the first bending actuation wire403 a. Accordingly, tension of the second bending actuation wire 403 bwill be changed and backlash will be created due to bending, thus makingfine adjustment difficult.

In this exemplary embodiment, the change in tension force caused by thefirst bending actuation wire 403 a can be measured and monitoredrespectively by the first sensor 171 and the second sensor 172 via thevoltage change induced by tension force. Then, the first feedback signal51 and the second feedback signal S2 are provided to the control member180 in response to the voltage change. After receiving and processingthe first feedback signal S1 and the second feedback signal S2, thecontrol member 180 will provide the first output signal S3 and thesecond output signal S4 to the first motor 161 and the second motor 162,separately. Then, the first motor 161 will be motionless in response tothe first output signal S3, while the second motor 162 will release thesecond bending actuation wire 403 b toward the direction of thesteerable member 100 until the predetermined length in response to thesecond output signal S4, so that the first bending actuation wire 403 aand the second bending actuation wire 403 b will be maintained under apredetermined tension again.

FIG. 43 is a block diagram illustrating a surgical instrument accordingto another exemplary embodiment of the present invention. FIG. 44 is aschematic view illustrating a surgical instrument according to anotherexemplary embodiment of the present invention. The end effector 300 maybe subjected to various external forces as it is brought into frequentcontact with a body wall or creates friction against a body materialwhile being pushed forward along a pathway in the body or createsreaction force when operates the end effector 300. In the traditionalsurgery, a surgeon feels such external force by their own finger(s).However, in the robotic surgery, surgeons cannot feel the external forcedirectly and all they can do is guess only by their observation orexperience.

Thus, in this embodiment, the surgical instrument 30 provided herein mayfunction together with a surgeon station 190 via a communication member191.

The first sensor 171 and the second sensor 172 as described above may beconfigured to determine whether an external force is applied or not,depending on whether the potential difference between the sensed valueand the value that tension in normal operation applied to the steerablemember 100 exceeds a preset threshold value ΔVth. When the externalforce is determined to be applied, the first sensor 171 and the secondsensor 172 will provide a first external-force signal S5 and a secondexternal-force signal S6 respectively to the control member 180. Thecontrol member 180 will further provide an instruction signal S7transmitted via communication member 191 in response to the firstexternal-force signal S5 and the second external-force signal S6.

The communication member 191 may be a build-in one within the controlmember 180 or an external one. Also, the communication member 191 mayuse any telecommunication technology in the art. For example, in someembodiments, the communication member 191 may comprise a wirelesstransmitter and a wireless receiver (not shown in FIGs). In otherembodiments, where the signal is digital, or digitized, and modulated bythe control member 180, wireless transmitter may be configured accordingto a standard protocol, e.g., Bluetooth®. Alternatively, any othersuitable configuration of hardwired or wireless transmitter, standard orproprietary, may be used. Further, wireless transmitter may include anantenna (not shown) extending therefrom to facilitate transmission ofthe signal to wireless receiver.

The surgeon station 190 is adapted to be manually manipulated bysurgeons to, in turn, control motion of the surgical instrument 30 inresponse to the surgeons' manipulation. In this embodiment, the surgeonstation 190 is configured to display information related to resistanceforce or vibration in response to the instruction signal S7 to surgeonstation 190. In one embodiment, the control member 180 as describedabove may comprise a haptic feedback controller (not shown in the FIGS)to process and transmit the instruction signal S7 in form of hapticfeedback. The haptic feedback may be provided through various forms, forexample, mechanosensation, including, but not limited to, vibrosensation(e.g. vibrations), force-sensation (e.g. resistance) andpressure-sensation, thermoperception (heat), and/or cryoperception(cold). The surgeon station 190 may comprise a haptic joystick (notshown in the FIGS) to transfer haptic feedback to the surgeons to informthem of the external force.

In other embodiments, the information related to resistance force orvibration may be shown as graphical information or acoustic information.The surgeon station 190 herein may be various types known in the artthat comprises a user's interface to display such graphical informationor acoustic information. With the surgical instrument 30 providedherein, the external force may be detected and monitored by the tensionmonitoring member 170 and be displayed in a visualized form or be sensedby haptic feedback. Thus, surgeons can apply additional force usingmaster device in the surgeon station timely against the external force,even in a tele-operation condition. Also, the accuracy to performsurgeries using the surgical instrument 30 will be increased.

In a further aspect, the present invention further provides apersonalized master controller for use with robots and the like, andparticularly to robotic surgical devices, systems, and methods. Inrobotically assisted surgery, the surgeon typically operates a mastercontroller to remotely control the motion of robotic surgical devices atthe surgical site. The master controller may be separated from thepatient by a significant distance (e.g., across the operating room, in adifferent room, or in a completely different building than the patient).Alternatively, a master controller may be positioned quite near thepatient in the operating room. Regardless, the master controller willtypically include one or more manual input handles so as to move asurgical apparatus 1 as shown in FIG. 1 based on the surgeon'smanipulation of the manual input handle. Typically, the manual inputhandle may be designed so as to allow smooth motion in the six degreesof freedom which may correspond to translations in three axes, as wellas rotation in three axes.

Further, in order to drive the surgical instrument 30 to perform varioussurgical operations, the manual input handle itself may provide a degreeof freedom for gripping motion. For example, a built-in gripping devicemay be further provided at the proximal end of the manual input handle,so that the gripping device may be levered to allow an operator toemulate the motion of scissors, forceps, or a hemostat and controlactuation of surgical instrument 30, such as, to actuate theend-effector 300 (see FIG. 1) to move tissue and/or other material atthe surgical site by gripping the same. However, such a gripping devicemay not be replaceable, and thus operators have no choice but are forcedto use the manual input handle with the gripping device that they maynot very familiar with. Precise control using a master controller forsurgical operations may thus become more difficult.

For the reasons outlined above, it would be advantageous to provideimproved devices, systems, and methods for robotic surgery, telesurgery,and other telerobotic applications. In an exemplary embodiment, apersonalized master controller is provided herein. FIG. 45 is a blockdiagram illustrating a personalized master controller according to anexemplary embodiment of the present invention. The personalized mastercontroller 9 may be coupled to a processor P (e.g. a computer) that iselectrically connected to the surgical apparatus 1. As provided herein,the personalized master controller 9 may comprise a control platform 90,a connecting part 91, and an interchangeable grip 92. As shown in FIG.45, the control platform 90 may be configured to define and input one ormore movement signals to control movement of the surgical apparatus 1(see, e.g. FIG. 1) via the processor P.

In some alternative embodiments, the control platform 90 may be a serialmanipulator, comprising: a number of rigid links connected with jointsas described in U.S. Pat. Nos. 7,714,836, 7,411,576, and 6,417,638,which are incorporated herein by reference in their entirety. Forexample, as shown in FIG. 46, this type of the control platform 90 maycomprise: a body 900 comprising a base 900 a, an input handle 901 and afirst plurality of sensors 902. The base 900 a may rotate with respectto a first axis A01 having a substantially vertical orientation. Theinput handle 901 may comprise a first link 903, a second link 904 and agimbal structure comprising an outer gimbal 907 and an inner gimbal 908.The first link 903 is pivoted to the body 900 via a first joint 905which allows the first link 903 to move with respect to a second axisA02 having a substantially perpendicular orientation relative to thefirst axis A01. The second link 904 is pivoted to the first link 903 viaa second joint 906 which allows the second link 904 to move with respectto a third axis A03 which is substantially parallel to the second axisA02.

A gimbal structure is mounted to the free end of the second link 904comprising an outer gimbal 907 and an inner gimbal 908. The outer gimbal907 is pivotally supported by the second link 904 and allowed to rotatewith respect to a fourth axis A04 which is substantially perpendicularto the third axis A03. The inner gimbal 908 is pivotally supported bythe outer gimbal 907 and allowed to rotate with respect to a fifth axisA05 which is substantially perpendicular to the fourth axis A04. Aconnecting part 91 (FIG. 48A) is mounted on the inner gimbal structure908 and allows the interchangeable grip 92 that is electricallyconnected thereto to rotate with respect to a sixth axis A06.

The connecting part 91 mounted on the inner gimbal structure 908electrically connects the input handle 901 and the interchangeable grip92. FIG. 47 is a perspective view illustrating a connecting partconnected to the control platform according to an exemplary embodimentof the present invention. In one embodiment, the connecting part 91 maybe a plug-and-socket type connector, but not limited to this. As shownin FIG. 47, in one embodiment, a one-prong plug 911 of the connectingpart 91 may be coupled to the inner gimbal 908 while a correspondingsocket structure 912 may be mounted at the distal end of theinterchangeable grip 92 (see FIGS. 48B, 48D and 48F), such that theinterchangeable grip 92 can be connected to on the inner gimbalstructure 908 and be allowed to rotate with respect a sixth axis A06which is substantially perpendicular to the fifth axis A05.Alternatively, in some embodiments, the one-prong plug 911 of theconnecting part 91 may be coupled to the distal end 924 of theinterchangeable grip 92 while the socket structure 912 may be mountedthe inner gimbal 908 (see FIG. 48).

Thus, the control platform 90 can provide six degrees of freedommovement including three translational degrees of freedom (in X, Y, andZ directions) and three rotational degrees of freedom (in pitch, yaw,and roll motion). The input handle 901 thereby can provide a pluralityof position parameters P1 when it is translatable itself or with themounted interchangeable grip 92 in X, Y, and Z direction with respect tothe control platform 90 and/or provide a plurality of orientationparameters P2 when it is rotatable itself or with the mountedinterchangeable grip 92 in pitch, yaw, and roll motion with respect tothe control platform 90.

In one embodiment, one or more first sensors 902 may be mounted to theinput handle 901 and configured to and generate one or more firstmovement signals S8 in response to the above-mentioned positionparameters P1 and/or the orientation parameters P2. The first sensors902, may, for example, be mounted to the first joint 905, the secondjoint 906 and/or the gimbal structure 907. In some embodiments, thefirst sensors 902 may be any type of sensors capable of measuring theposition parameters P1 and/or the orientation parameters P2 based on thestatus or changes such as position, orientation, force, torque, speed,acceleration, strain, deformation, magnetic field, angle and/or light(but not limited to this) caused by the motion of the input handle 901and/or mounted interchangeable grip 92. For example, the first sensors902 may be pressure or force sensor, including but not limited to apiezoelectric sensor, a simple piezoelectric crystal, a Hall-Effect or aresistive strain gauge sensor, etc., all of which can be eitherstand-alone or integrated with signal-conditioning electronics(Wheatstone bridge, low-noise amplifier, A/D converter, etc.) into asingle chip or single package sealed module. In other embodiments, maybe an angle sensor, or a rotational sensor, but not limited to this. Ina specific embodiment, the first sensor 902 may be a Hall-Effect sensor.As known in the art, the Hall-Effect sensor may be used in the presenceof a corresponding magnet element (not shown in the FIGs.) to sense themagnetic field responding to the position parameter P1 and/or theorientation parameter P2. Then, the first sensors 902 may produce afirst movement signal S8 to control movement of the surgical apparatus 1(e.g., roll, translation, or pitch/yaw movement) accordingly.

FIGS. 48A to 48F are perspective views illustrating an interchangeablegrip according to various exemplary embodiments of the presentinvention. In one embodiment, the interchangeable grip 92 providedherein may comprise a detachable handle 921 to mimic actual handles frommanual surgical instruments. i.e., it may be the same size and shape,and can be squeezable or fixed, in order to provide realism to thesurgeon. For example, two grip levers 922, 923 shown in FIG. 48 A may bepivoted at the proximal end of the detachable handle 921 so as toprovide a degree of freedom of pinching or grasping motion. Both griplevers 922, 923 may be allowed to move toward each other relative to thedetachable handle as indicated by arrows H to provide a degree offreedom of pinching or grasping motion. To mimic actual standardsurgical handles depending on a field, surgeon, or operation, thedetachable handle 921 and grip levers 922, 923 may be designed to beinterchangeable as various types of surgical tools such as tweezers orlaparoscopic hand Instruments as shown in FIG. 48C to 48F, respectively.

Also, in some embodiments, the detachable handle 921 may be mounted toor detach from the socket structure 912 at its distal end 924. Thesocket structure 912 provided herein may be capable of electricallyconnecting to or disconnecting from the one-prong plug 911 of theconnecting part 91 see FIGS. 48B, 48D and 48F), so that the detachablehandle 921 may be instrumented accordingly to receive relevant grippingmotion input from the surgeon and the corresponding control signals aresubsequently produced and transmitted to the surgical apparatus 1 viathe control platform 90.

To sense gripping motion of the interchangeable grip 92, in oneembodiment, the detachable handle 921 may define an inner hollow tubularspace where a second sensor 925 may be housed to sense at least oneparameter P3 based on the status or changes such as position,orientation, force, torque, speed, acceleration, strain, deformation,magnetic field, angle and/or light (but not limited to this) caused bythe motion of the grip levers 922, 923.

In some embodiments, the second sensor 925 may be any type of sensorsknown in the art. For example, the second sensors 905 may be pressure orforce sensor, including but not limited to a piezoelectric sensor, asimple piezoelectric crystal, a Hall-Effect or a resistive strain gaugesensor, etc., all of which can be either stand-alone or integrated withsignal-conditioning electronics (Wheatstone bridge, low-noise amplifier,A/D converter, etc.) into a single chip or single package sealed module.In other embodiments, the second sensors 925 may be an angle sensor, ora rotational sensor, but not limited to this. In a specific embodiment,the second sensor 902 may be a Hall-Effect sensor. The Hall-Effectsensor may be used in the presence of a corresponding magnet element(not shown) to sense the magnetic field as known in the art, such thatthe Hall-Effect sensor may measure the gripping parameters P3 and/or P4based on the status or changes of the magnetic field caused by themotion of the grip levers 922, 923. Then, the Hall-Effect sensor mayproduce a second movement signal S9 that can control the movement of theend-effector 300 shown in FIG. 1 accordingly. (e.g. opening and closing(gripping) movement of the end-effector 300 that may be a grippingdevice (e.g., jaws or blades).)

FIG. 49 is a view schematically illustrating a personalized mastercontroller according to another exemplary embodiment of the presentinvention. FIG. 50 is view schematically illustrating parts of thecontrol platform of the personalized master controller in FIG. 49. Inthis embodiment, the control platform 90 may be a device comprisingparallel kinematics structures, in particular, a Delta parallelkinematics structure device (for example, as described in US2008/0223165 A1 which is incorporated herein by reference in itsentirety). As shown in FIG. 49, the control platform 90 is adapted toprovide up to six degrees of freedom (i.e. up to three translationaldegrees of freedom in X, Y, and Z directions and up to three rotationaldegrees of freedom in pitch, yaw, and roll orientations to provide aposition parameter and an orientation parameter, respectively.

In this embodiment, the control platform 90 may comprise: a base member93, a moveable member 94, and three parallel kinematics chains 95coupling the base member 93 and the moveable member 94, respectively.Each parallel kinematics chain 95 having a first arm 951 moveable in arespective movement plane 950 which is at a distance to a symmetry axis(i.e. the central line perpendicular to the base member 93). Each firstarm 951 is coupled with its associated mounting member 96 such that eachfirst arm 951 may be rotated or pivoted with respect to the associatedmounting member 96 and, thus, with respect to the base member 93.

The parallel kinematics chains 95 comprising a second arm 952 may becoupled to the moveable member 94. Each second arm 952 may be consideredas parallelogram including two linking bars 952 a, 952 b. At proximalend of the second arm 952, each linking bar 952 a and 952 b may becoupled with the moveable member 94 by a joint or hinge 97. At thedistal end of the second arm 952, each linking bar 952 a, 952 b arecoupled with an end of its associated first arm 951 by a joint or hinge97. Each second arm 952, particularly each linking bar 952 a, 952 b, mayhave two rotational degrees of freedom at both ends.

Thus, each kinematics chain 95 connected between the base member 93 andthe moveable member 94 may be moved in a movement space defined by thebase member 93, the moveable member 94, and three parallel kinematicschains 95 to provide up to three translational degrees of freedom (alongthe X, Y, and Z directions, respectively as shown in FIG. 50),generating one or more position parameters P1. More details for theDelta parallel kinematics structure device may be referred to, forexample, US 2008/0223165 A1 which has been incorporated herein byreference in its entirety.

In addition, up to three rotational degrees of freedom may be providedby a wrist structure 940 coupled to the moveable member 94, comprising athree pivotable connections 941, 942 and 943, for example in form ofpivot joints. Each of the pivotable connections 941, 942 and 943provides a rotational degree of freedom with respect to the moveablemember 94 (in yaw, pitch, and roll orientations respectively in FIG.51), and generates one or more orientation parameters P2 thereby.

There are a plurality of first sensors 902 provided to detect one ormore position parameters P1 and/or the orientation parameters P2 causedby the movement of three parallel kinematics chains 95 and the moveablemember 94, followed by generating first movement signals S8 in responseto the parameter(s) P1 and or P2. For example, some first sensors 902may be installed to each mounting member 96 respectively to detect atleast one parameter caused by the motion of the associated first arm951. Other first sensors 902 may be installed to all or parts of jointor hinge 97 respectively to detect at least one parameter caused by themotion of the associated second arm 952. Alternatively, three firstsensors 902 may be provided at three pivotable connections 941, 942 and943 respectively.

FIG. 51 is an enlarged view of a portion of FIG. 49 showing theinterchangeable grip being attached to the moveable member of thecontrol platform according to an exemplary embodiment. FIG. 52 is alsoan enlarged view of a portion of FIG. 49 showing the interchangeablegrip being detached from the moveable member of the control platformaccording to an exemplary embodiment. As shown in FIG. 52, a connectingpart 91 is further mounted on the pivotable connection 943, such that itcan electrically connect the input handle 901 and the interchangeablegrip 92. As shown in FIG. 52, in one embodiment, the connecting part 91may comprise be a plug-and-socket type connector, but not limited tothis. For example, a one-prong plug 911 of the connecting part 91 may becoupled to the detachable handle 921 of the interchangeable grip 92 viaa thread 913, while a corresponding socket structure 912 may be mountedat the pivotable connection 943, so that that the interchangeable gripmay be attached to (see FIG. 51) or detached from (see FIG. 52) thepivotable connection 943 and allowed to rotate with respect to therotational axis A10 of the pivotable connection 943.

As seen above, several exemplary embodiments of a surgical apparatushave been described. However, these exemplary embodiments are forillustrative purposes only. For example, the above-described surgicalinstruments may be configured as individual surgical apparatuses, orthey may be applied to a variety of medical devices, such as a lumenunit or imaging unit with a working channel, as well as to a surgicalapparatus with an end effector. Furthermore, various embodiments of asteerable member may be integrated or otherwise adapted for a variety ofsurgical apparatuses, including, but not limited to, catheters,endoscopes, and surgical robots that are bendable at the distal endthereof.

As used herein, the terms “comprises,” “comprising,” “includes,”“including,” “has,” “having,” or any other variation thereof, areintended to cover a non-exclusive inclusion. For example, a process,product, article, or apparatus that comprises a list of elements is notnecessarily limited only those elements but may include other elementsnot expressly listed or inherent to such process, product, article, orapparatus.

Furthermore, the term “or” as used herein is generally intended to mean“and/or” unless otherwise indicated. For example, a condition A or B issatisfied by any one of the following: A is true (or present) and B isfalse (or not present), A is false (or not present) and B is true (orpresent), and both A and B are true (or present). As used herein, a termpreceded by “a” or “an” (and “the” when antecedent basis is “a” or “an”)includes both singular and plural of such term, unless clearly indicatedotherwise (i.e., that the reference “a” or “an” clearly indicates onlythe singular or only the plural). Also, as used in the descriptionherein, the meaning of “in” includes “in” and “on” unless the contextclearly dictates otherwise.

It will also be appreciated that one or more of the elements depicted inthe drawings/figures can also be implemented in a more separated orintegrated manner, or even removed or rendered as inoperable in certaincases, as is useful in accordance with a particular application.Additionally, any signal arrows in the drawings/figures should beconsidered only as exemplary, and not limiting, unless otherwisespecifically noted. The scope of the disclosure should be determined bythe following claims and their legal equivalents.

In some embodiments is a surgical apparatus comprising: a surgicalapparatus comprising: a steerable member that is bendable and comprisesa plurality of bending segments with channels therein; and a pluralityof bending actuation wires that are arranged to pass through thesteerable member and cause the steerable member to bend, the steerablemember comprising at least one lumen through which the bending actuationwires pass, and the lumen being partially open outward. In someembodiments, the bending segments are hinged to adjacent bendingsegments. In other embodiments, the connecting parts of each bendingsegment are pinned to an adjacent bending segment. In other embodiments,the connecting parts of each bending segment are accommodated in recessparts of the adjacent bending segment and hinged thereto. In otherembodiments, each connecting part comprises a protrusion with a roundsurface, and each recess part is shaped to accommodate each connectingpart such that each connecting part may rotate. In other embodiments,each connecting part comprises a protrusion with a linear edge, and eachrecess part is shaped like a v-shaped notch such that each connectingpart may rotate while in linear contact with each recess part. Inalternative embodiments, a pair of connecting parts are provided facingeach other on one side of the length of each bending segment, a pair ofrecess parts are provided facing each other on the other side of thelength of each bending segment, and the pair of connecting parts and thepair of recess parts are arranged in a direction perpendicular to eachother so as to permit bending in at 2 degrees of freedom. In otherembodiments, four lumens are formed along the length of each bendingsegment, and each lumen passes through at least a portion of aconnecting part or a recess part. In some aspects, each lumen comprisesa closed lumen portion and an open lumen portion, and a portion of eachlumen passing through the connecting part or the recess part forms aclosed lumen portion and the other side of the connecting part or therecess part forms an open lumen portion. In other embodiments, eachbending segment has four lumens along the length, and each lumen islocated between the locations of the connecting part and recess partalong the circumference. In other embodiments, each lumen comprises aclosed lumen portion and an open lumen portion, wherein the closed lumenportion is formed at the middle of the lumen length and the open lumenportion is formed on both sides of the closed lumen portion. In someembodiments, the steerable member comprises a plurality of plate-likebending segments and connecting parts of flexible material locatedbetween the bending segments. In other embodiments, the connecting partsare formed integrally between the bending segments and extend from twoedge of the channels provided at the center of the bending segments toan outward direction, and the connecting parts are formed in a directionperpendicular to adjacent connecting parts. In other embodiments, thebending actuation wires are arranged to pass through the bendingsegments and the connecting parts, and each lumen with a bendingactuation wire provided therein has a structure in which a portionlocated at a connecting part forms a closed lumen and a portion formedat a bending segment is open outward. In other embodiments, theconnecting parts are configured to connect the centers of adjacentbending segments.

In some embodiments of the surgical apparatus further comprises an endeffector provided at the distal end of the steerable member. In someembodiments, the end effector is connected to an effector actuation wirelocated in the channels of the steerable member such that it may beactuated by moving the effector actuation wire, and at least part of theend effector is detachably provided at the distal end of the effectoractuation wire. In some embodiments, at least part of the end effectoris magnetically connected to the distal end of the effector actuationwire. In other embodiments, the end effector comprises an effectormodule comprising: an instrument portion for performing a surgicaloperation; and an actuation portion connected to the effector actuationwire to actuate the instrument portion, wherein at least either theproximal end of the effector module or the distal end of the effectoractuation wire comprises a magnetic body. In some embodiments, thesurgical apparatus further comprises an effector actuation wire that islocated in the channels of the steerable member and connected to the endeffector to actuate the end effector, and the end effector furthercomprises an elastic body that is configured to produce an elastic forcein the opposite direction to a force applied by the effector actuationwire. In other embodiments, the effector actuation wire is configuredsuch that the end effector operates in a first mode when pulled by theeffector actuation wire and operates in a second mode while not pulledby the effector actuation wire. In other embodiments, a forceps of theend effector is closed in the first mode and open in the second mode. Insome embodiments, the end effector comprises: an instrument portion forperforming a surgical operation; an actuation portion connected to theeffector actuation wire to actuate the instrument portion; and a bodyportion forming a path along which the actuation portion reciprocates,wherein the elastic body is located at the proximal end of the actuationportion and applies an elastic force in a direction that pushes theactuation portion. In other embodiments, the actuation portion and thedistal end of the effector actuation wire are configured to beattachable to or detachable from each other. In other embodiments, atleast either the actuation portion or the distal end of the effectoractuation wire comprises a magnetic body.

In some embodiments of the surgical apparatus, a wire termination memberfor fixing the distal ends of the bending actuation wires is provided atthe distal end of the steerable member. In some embodiments, the wiretermination member has a thread such that the bending actuation wiresare fixed by screwing the wire termination member to the distal end ofthe steerable member. In other embodiments, the bending actuation wiresare arranged to be fixed by being pushed while wound between the distalend of the steerable member and the wire termination member. In someembodiments, the wire termination member comprises at least one holethrough which the distal ends of the bending actuation wires pass, andthe wire termination member is provided at the distal end of thesteerable member. In other embodiments, the holes in the wiretermination member are formed at locations corresponding to the lumensin the steerable member. In other embodiments, the surgical apparatusfurther comprises an end effector provided at the distal end of thesteerable member, the wire termination member being the end effector.

In some embodiments is a surgical apparatus comprising: a steerablemember that is bendable and comprises a plurality of bending segmentswith channels therein; a plurality of bending actuation wires that arearranged to pass through the steerable member and cause the steerablemember to bend, and the steerable member comprising at least one lumenthrough which the bending actuation wires pass; wherein the surgicalapparatus further comprises: a flexible member comprising a flexiblematerial that is provided at the proximal end of the steerable member;and at least one sleeve forming a path of travel of a wire passingthrough the steerable member or the flexible member, both ends of whichare fixed to the inside thereof. In some embodiments, the wire comprisesthe bending actuation wires. In some embodiments, the body of the sleeveis longer than the longest possible path that is formed between twopoints at which both opposite ends of the sleeve are fixed when thesteerable member or the flexible member is bent, in order to minimizethe effect of the bending of the steerable member or flexible member onthe movement of the wire in the sleeve. In some embodiments, thesteerable member and the flexible member have a hollow space for thesleeve to be placed therein. In some embodiments, a second sleeve out ofthe at least one sleeve forms a path for the distal end bendingactuation wire, one end of the second sleeve being fixed at the proximalend of the distal end steerable portion or the distal end of theproximal end steerable portion and the other end being fixed at theproximal end of the flexible member. In other embodiments, the secondsleeve comprises an elastic material so that the distal end bendingactuation wire is located along a curved path when the distal endsteerable portion is bent. In some embodiments a third sleeve out of theat least one sleeve forms a path along for the proximal end bendingactuation wire, one end of the third sleeve being fixed at the proximalend of the proximal end steerable portion or the distal end of theflexible member and the other end being fixed at the proximal end of theflexible member. In other embodiments, the third sleeve comprises anelastic material so that the proximal end bending actuation wire islocated along a curved path when the proximal end steerable portion isbent.

In some embodiments is a surgical apparatus comprising: (Amended) Asurgical apparatus comprising: a steerable member that is bendable andcomprises a plurality of bending segments with channels therein; aplurality of bending actuation wires that are arranged to pass throughthe steerable member and cause the steerable member to bend, and thesteerable member comprising at least one lumen through which the bendingactuation wires pass; a flexible member comprising a flexible materialthat is provided at the proximal end of the steerable member and forms apath along which the bending actuation wires pass; and a manipulatingpart that is provided at the proximal end of the flexible member foractuating the bending actuation wires, wherein the proximal ends of thebending actuation wires are attachable to or detachable from themanipulating part. In other embodiments, the proximal ends of thebending actuation wires and effector actuation wire are magnetically anddetachably connected to the manipulating part.

In some embodiments is a surgical apparatus, wherein the bendingactuation wires comprise a first bending actuation wire, and a secondbending actuation wire that causes the steerable member to bend in theopposite direction to the first bending actuation wire, wherein screwmembers rotating in the same direction are provided at the proximal endof the first bending actuation wire and the proximal end of the secondbending actuation wire and are configured to move in synch with eachother in opposite directions. In some embodiments, the proximal end ofthe first bending actuation wire is configured to move along a firstthread, and the proximal end of the second bending actuation wire isconfigured to move along a second thread oriented in the oppositedirection to the first thread. In other embodiments, the first tread andthe second thread are configured to rotate in the same direction by asingle driving part. In other embodiments, the screw members arebi-directional lead screws, each having first and second thread portionsformed on a single body. In other embodiments, the screw memberscomprise: a first lead screw with a first thread; and a second leadscrew with a second thread, wherein the first lead screw and the secondlead screw are configured to move in sync with each other by a gear androtate simultaneously by a single driving part.

In some embodiments of the surgical apparatus, the steerable member hasa geometric shape configured to bend more easily at the distal end thanat the proximal end. In some embodiments, the bending segments have ageometric shape configured such that the steerable member bends moreeasily closer to its proximal end. In some embodiments, the bendingsegments have lumens formed at a distance from the center of across-section of the steerable member, and the closer to the proximalend of the steerable member, the more distant the lumens in the bendingsegments get from the center of the cross-section of the steerablemember. In some embodiments, the steerable member further comprises aplurality of connecting parts located between the bending segments,wherein the connecting parts have a geometric shape configured such thatthe steerable member bends more easily closer to its proximal end. Inother embodiments, the connecting parts are configured to have a smallersectional width toward the proximal end of the steerable member so thatthe corresponding parts of the steerable member bend more easily. Inother embodiments, the connecting parts are configured to increase indiameter along the length toward the proximal end of the steerablemember so that the corresponding parts of the steerable member bend moreeasily.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable; an end effector provided at the distal end ofthe steerable member; and an effector actuation wire that is arranged topass through the steerable member and connect to the end effector toactuate the end effector, the end effector comprising an elastic bodythat produces an elastic force in the opposite direction to the forceapplied by the effector actuation wire. In some embodiments, the endeffector is configured to operate in a first mode when pulled by theeffector actuation wire and is configured to operate in a second mode bythe elastic force of the elastic body while not pulled by the effectoractuation wire. In other embodiments, the end effector is actuated insuch a way that surgical elements at the distal end are closed in thefirst mode and open in the second mode. In other embodiments, the endeffector further comprises an effector module comprising: an instrumentportion for performing a surgical operation; an actuation portionconnected to the effector actuation wire to actuate the instrumentportion; and a body portion forming a path along which the actuationportion reciprocates. In other embodiments, the elastic body is locatedat the proximal end of the actuation portion for applying an elasticforce to push the actuation portion in the direction of the distal end.In some embodiments, the effector module and the distal end of theeffector actuation wire are configured to be attachable to or detachablefrom each other. In other embodiments, the effector module and theeffector actuation wire are magnetically connected together.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable; a plurality of bending actuation wires that arearranged to pass through the steerable member and cause the steerablemember to bend; and a wire termination member provided at the distal endof the steerable member to fix the bending actuation wires, wherein thewire termination member has a thread for engaging with the distal end ofthe steerable member, such that the bending actuation wires are fixed byscrewing the wire termination member and the steerable member together.In some embodiments, the bending actuation wires are configured to befixed by winding between the distal end of the steerable member and thewire termination member. In other embodiments, the wire terminationmember comprises at least one hole through which the distal ends of thebending actuation wires pass, and the wire termination member isprovided at the distal end of the steerable member. In otherembodiments, the holes in the wire termination member are formed atlocations corresponding to the lumens in the steerable member. In someembodiments, the end effector is provided on the wire terminationmember. In some embodiments, the surgical apparatus further comprises anend effector provided at the distal end of the steerable member, thewire termination member being the end effector.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable; a first bending actuation wire that is arrangedto pass through the steerable member to cause the steerable member tobend in a first direction; a second bending actuation wire that isarranged to pass through the steerable member to cause the steerablemember to bend in a second direction which is opposite to the firstdirection; and at least one screw member to which the proximal end ofthe first bending actuation wire and the proximal end of the secondbending actuation wire are coupled, such that the steerable member bendsin the first or second direction by rotating the at least one screwmember. In some embodiments, the at least one screw member is arrangedto rotate about the longitudinal axes of the first and second bendingactuation wires. In some embodiments, the proximal end of the firstbending actuation wire and the proximal end of the second bendingactuation wire are configured to move in sync with each other inopposite directions by rotation of the at least one screw member. Inother embodiments, when the at least one screw member is configured torotate in a first direction of rotation to move the proximal end of thefirst bending actuation wire backward and the proximal end of the secondbending actuation wire forward, thereby causing the steerable member tobend in the first direction, and a second direction of rotation to movethe proximal end of the first bending actuation wire forward and theproximal end of the second bending actuation wire backward, therebycausing the steerable member to bend in the second direction. In someembodiments, the proximal end of the first bending actuation wire isengaged with and moves along a first thread, and the proximal end of thesecond bending actuation wire is engaged with and moves along a secondthread oriented in the opposite direction to the first thread. In otherembodiments, the first thread and the second thread are configured torotate in the same direction, such that the proximal end of the firstbending actuation wire and the proximal end of the second bendingactuation wire are configured to move in sync with each other inopposite directions. In some embodiments, the at least one screw memberis a bi-directional lead screw having first and second thread portionsformed on a single body.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable; and a plurality of bending actuation wires thatare arranged to pass through lumens in the steerable member and causethe steerable member to bend, wherein the steerable member has ageometric shape configured such that the steerable member bends moreeasily closer to its distal end. In some embodiments, the geometricshape is configured to provide a smaller radius of curvature closer tothe proximate end of the steerable member.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable and comprises a plurality of bending segmentswith channels therein; a plurality of bending actuation wires that arearranged to pass through the steerable member and cause the steerablemember to bend; and a lateral supporting member that comprises anelastic material and exerts a restoration force for returning thesteerable member to the initial position after bending. In someembodiments, the surgical apparatus further includes a plurality oflateral supporting members wherein the number of lateral supportingmembers is equal to the number of bending actuation wires. In someembodiments, the lateral supporting member is configured to bend in syncwith the steerable member by the movement of the bending actuationwires, and the lateral supporting member has an elasticity configuredsuch that it returns to its original shape when the force exerted on thebending actuation wires is released, thus bringing the steerable memberback to the initial position. In some embodiments, the shape of thelateral supporting member before bending is linear. In some embodiments,the shape of the lateral supporting member before bending is bent to oneside. In other embodiments, the lateral supporting members is configuredin a tube shape, and a bending actuation wire is located inside thelateral supporting member.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable and comprises a plurality of bending segmentswith channels therein and a plurality of connecting segments locatedbetween the bending segments; and a plurality of bending actuation wiresthat are arranged to pass through the steerable member and cause thesteerable member to bend, wherein two ends of each connecting segmentare hinged to different bending segments. In some embodiments, eachconnecting segment comprises: a pair of bodies that form portions hingedto the bending segment; and a guide member that joins together the pairof bodies and has a hollow space inside it where the bending actuationwires are located. In some embodiments, a bending segment connected toone end of each connecting segment is rotatable about a first hingeshaft, and a bending segment connected to the other end is rotatableabout a second hinge shaft, and the first hinge shaft and the secondhinge shaft are parallel to each other. In some embodiments, eachconnecting segment is arranged in a different direction from adjacentconnecting segments to cause the connected bending segments to bendabout different axes of rotation, in order to enable the steerablemember to bend at least 2 degrees of freedom. In some embodiments, eachbending segment comprises a plurality of lumens where the bendingactuation wires are located, the lumens being arranged to not passthrough the portions hinged to the connecting segment. In someembodiments, the bending segments are rotatably connected to theconnecting segments, and the hinge shafts about which the bendingsegments rotate are in the same plane as the ends of the lumens wherethe bending actuation wires are located.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable and comprises a plurality of bending segments,wherein each bending segment includes at least an intermediate jointhaving a first link portion and a second link portion and wherein theintermediate joint is arranged along a longitudinal axis direction ofeach bending segment; a plurality of bending actuation wires that arearranged to pass through the steerable member for causing the steerablemember to bend; wherein the steerable member further comprises at leastone lumen through which the bending actuation wires pass; and theintermediate joint further comprises a tension-regulating member whichis coupled to the first link portion and the second link portion and isconfigured to regulate the tension of bending actuation wires bycompensating the elongation of the bending actuation wires when bendingsegments bend, whereby the length of bending actuation wires is alteredand kept in a predetermined tension. In other embodiments, the firstinterfacing half has a protrusion end, and the second interfacing halfcorrespondingly has a recess end. In other embodiments, the firstinterfacing half has a recess end, and the second interfacing halfcorrespondingly has a protrusion end. In some embodiments, theelongation of the bending actuation wires is compensated by being offsetof two off-axis hinges. In some embodiments, the bending segmentincludes a series of interstacked intermediate joints.

In some embodiments is a surgical apparatus, comprising: a steerablemember that is bendable and comprises a plurality of bending segmentsand a plurality of lumens; a bending actuation member, comprising afirst bending actuation wire and a second bending actuation wire thatare arranged to pass through each lumen separately and cause thesteerable member to bend; a tension monitoring member, comprising: afirst sensor that is coupled to the first bending actuation wire andconfigured to provide a first feedback signal responsive to sensingchange in tension force of the first bending actuation wire between thepre-bending and the desired bending motion of the steerable member; asecond sensor that is coupled to the second bending actuation wire andconfigured to provide a second feedback signal responsive to sensingchange in tension force of the second bending actuation wire between thepre-bending and the desired bending motion of the steerable member; adrive member, comprising: a first motor, coupled to the first bendingactuation wire and adapted to actuate the first bending actuation wire;a second motor coupled to the second bending actuation wire and adaptedto actuate the second bending actuation wire; a control member that iselectrically connected to the tension monitoring member and the drivemember, wherein the control member is configured to provide: a firstoutput signal responsive to the first feedback signal, so that the firstmotor is driven to adjust the length of the first bending actuation wireto maintain a predetermined tension; and a second output signalresponsive to the second feedback signal, so that the second motor isdriven to adjust the length of the second bending actuation wire tomaintain a predetermined tension. In some embodiments, the secondbending actuation wire is moveable in an opposite direction of the firstbending actuation wire. In some embodiments, when the first bendingactuation wire is configured to be actuated to bend the steerablemember, and the second bending actuation wire is configured to be drivenby the second motor, so that the second bending actuation wire isreleased and maintained under the predetermined tension in response tothe second output signal. In some embodiments, the first sensor or thesecond sensor is load cell. In some embodiments, the first sensor isfurther configured to provide a first external-force signal responsiveto sensing an external force applied to the steerable member. In someembodiments, the second sensor is further configured to provide a secondexternal-force signal responsive to sensing an external force applied tothe steerable member. In other embodiments, the control member isfurther configured to provide an instruction signal in response to thefirst external-force signal or the second external-force signal. Inother embodiments, the control member further comprises a hapticfeedback controller that is configured to process and transfer theinformation in the form of haptic feedback. In other embodiments, thefirst motion transmitting unit or the second motion transmitting unit isa lead screw or a ball screw.

In some embodiments is a personalized master controller for a surgicalapparatus, comprising: a control platform that is configured to defineand input one or more movement signals to the surgical robot, whereinthe control platform comprises: an input handle that is translatable ina first plurality of degrees of freedom to provide a plurality ofposition parameters and/or rotatable in a second plurality of degrees offreedom to provide a plurality of orientation parameters; a plurality offirst sensors that are coupled to the input handle and configured togenerate first movement signals in response to the position parametersand/or the orientation parameters of the input handle; a connecting partmounted to the input handle and electrically connected to the inputhandle; and an interchangeable grip, comprising: a detachable handlethat is electrically connected the connecting part; one or more griplevers pivoted with respect to the detachable handle, wherein each griplever is moveable in a third degree of freedom relative to thedetachable handle so as to provide a gripping motion parameter; and asecond sensor that is coupled to the detachable handle and configured togenerate a second movement signal to the control platform in response tothe gripping motion parameter. In some embodiments, the first pluralityof sensors or the second plurality of sensors includes a rotary encoder,a Hall effector sensor, an angle sensor, a rotational sensor or anycombination thereof. In some embodiments, the connecting part furthercomprises a thread that is coupled to the detachable handle and has afirst electrical connecting terminal. In other embodiments, thedetachable handle further comprises a second electrical connectingterminal that is electrically connected to the first electricalconnecting terminal. In some embodiments, the interchangeable gripcomprises two grip levers that are correspondingly pivoted to thedetachable handle and allow to move toward each other relative to thedetachable handle.

What is claimed is:
 1. A surgical apparatus comprising: a steerablemember that is bendable and comprises a plurality of bending segments,wherein each bending segment includes an intermediate joint having atleast a first link portion and a second link portion spaced from thefirst link portion by a gap, and wherein the intermediate joint isarranged along a longitudinal axis direction of each bending segment; aplurality of bending actuation wires disposed through the steerablemember; a first off-axis hinge and a second off axis hinge, each of thefirst and second off-axis hinges extending across the gap between thefirst link portion and the second link portion and the first and secondoff-axis hinges spaced from one another in a direction other than thecentral, longitudinal axis of the intermediate joint, each off-axishinge comprising: a first interfacing half having a first protrusion endand a second protrusion end coupled to the first link portion; and asecond interfacing half having a first recess end and a second recesscoupled to the second link portion, wherein the first interfacing halfand the second interfacing half pivot with respect to each other to format least one pivot point that is offset from the central, longitudinalaxis of the intermediate joint, so that the intermediate joint isallowed to bend about a single axis through the at least one pivotpoint, and wherein the first link portion and the second link portionare positionable with respect to each other wherein in a first relativeposition thereof, the first protrusion end of the first interfacing halfis in contact with the first recess end of the second interfacing half,and the second protrusion end of the first interfacing half is incontact with the second recess end of the second interfacing half, andin a second relative position thereof, the first protrusion end of thefirst interfacing half is in contact with the first recess end of thesecond interfacing half, and the second protrusion end of the firstinterfacing half is spaced from the second recess end of the secondinterfacing half.
 2. The surgical apparatus of claim 1, wherein thefirst link portion and the second link portion are positionable withrespect to each other in a third relative position thereof, where thefirst protrusion end of the first interfacing half is spaced from thefirst recess end of the second interfacing half, and the secondprotrusion end of the first interfacing half is in contact with thesecond recess end of the second interfacing half.
 3. The surgicalapparatus of claim 1, wherein the link portions further include at leastone actuation wire lumen extending therethrough, and an actuation wireof the bending actuation wires extends therethrough.
 4. The surgicalapparatus of claim 1, wherein elongation of the bending actuation wireis compensated by being offset by the motion of the first or the secondoff-axis hinges.
 5. The surgical apparatus of claim 1, wherein theplurality of bending segments include a series of inter-stackedintermediate joints.
 6. The surgical apparatus of claim 1, wherein thefirst and second link portions are disk shaped planar members having atleast one surface, and in the first relative positions thereof, thefacing at least surface of the first and second link portions areparallel to one another.
 7. The surgical apparatus of claim 3, whereinthe link portion includes an outer circumferential wall, wherein theouter circumferential wall extends over a first portion of the at leastone actuation wire lumen, and a second portion of the at least oneactuation wire lumen is open at the circumferential wall.
 8. Thesurgical apparatus of claim 7, wherein each link portion includes acentral lumen, and the at least one actuation wire lumen is locatedradially outwardly of the location of the central lumen.
 9. A surgicalapparatus comprising: a steerable member that is bendable and comprisesa plurality of bending segments, wherein each bending segment includesan intermediate joint having at least a first body portion and a secondbody portion spaced from the first link portion by a gap, wherein thefirst body portion includes at least a first body surface, the secondbody portion includes a second body surface facing the first bodysurface across the gap, and wherein the intermediate joint is arrangedalong a longitudinal axis direction of each bending segment; a firstinterfacing half and a second interfacing half, extending from the firstbody surface and a third interfacing half and a fourth interfacing halfextending from the second body surface, the first interfacing half andthe third interfacing half cooperatively arranged to form a firstmulti-axis hinge joint in the gap and the second interfacing half andthe fourth interfacing half cooperatively arranged to form a secondmulti-axis hinge in the gap, the first interfacing half and the secondinterfacing half spaced from one another in a direction other than thecentral, longitudinal axis of the intermediate joint, and the thirdinterfacing half and the fourth interfacing half spaced from one anotherin a direction other than the central, longitudinal axis of theintermediate joint: the first interfacing half having a first protrusionand a second protrusion, the first and second protrusions spaced fromone another in a direction other than the direction between the firstinterfacing half and the second interfacing half, the first and secondprotrusions located at the distal end of the first interfacing half; anda third interfacing half having a first recess and a second recess atthe distal end thereof, the first and second protrusions spaced from oneanother in a direction other than the direction between the thirdinterfacing half and the fourth interfacing half; wherein the first linkportion and the second link portion are moveably positionable withrespect to each other, wherein in a first relative position thereof, thefirst protrusion of the first interfacing half is in contact with thefirst recess of the third interfacing half, and the second protrusion ofthe first interfacing half is in contact with the second recess of thethird interfacing half, and in a second relative position thereof, thefirst protrusion of the first interfacing half is in contact with thefirst recess of the third interfacing half, and the second protrusion ofthe first interfacing half is spaced from the second recess of the thirdinterfacing half.
 10. The surgical apparatus of claim 9, wherein thefirst link portion and the second link portion are positionable withrespect to each other in a third relative position thereof, where thefirst protrusion of the first interfacing half is spaced from the firstrecess of the third interfacing half, and the second protrusion of thefirst interfacing half is in contact with the second recess of the thirdinterfacing half.
 11. The surgical apparatus of claim 9, wherein thelink portions further include at least one actuation wire lumenextending therethrough, and an actuation wire of the bending actuationwires extends therethrough.
 12. The surgical apparatus of claim 9,wherein elongation of the bending actuation wire is compensated by beingoffset by the motion of the first or the second off-axis hinges.
 13. Thesurgical apparatus of claim 9, wherein the plurality of bending segmentsinclude a series of inter-stacked intermediate joints.
 14. The surgicalapparatus of claim 9, wherein the first and second link portions aredisk shaped planar members having at least one surface, and in the firstrelative positions thereof, the facing at least surface of the first andsecond link portions are parallel to one another.
 15. The surgicalapparatus of claim 11, wherein the link portion includes an outercircumferential wall, wherein the outer circumferential wall extendsover a first portion of the at least one actuation wire lumen, and asecond portion of the at least one actuation wire lumen is open at thecircumferential wall.
 16. The surgical apparatus of claim 15, whereineach link portion includes a central lumen, and the at least oneactuation wire lumen is located radially outwardly of the location ofthe central lumen.